Susong Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SUSONG DERMATOLOGY PLLC

Practice address

2158 Northgate Park LN Ste 106
Chattanooga, TN 37415-6911

Phone

(423) 888-3376

Fax

(423) 870-1480

NPI assigned

Jun 25, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jason Susong, MD

Title

Ceo

Phone

(423) 888-3376

Specialties & licenses 2

Addresses

Other names 1

• Susong Dermatology Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1568032233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 NORTHGATE PARK LN STE 106",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156911",
            "telephone_number": "423-888-3376",
            "fax_number": "423-870-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 NORTHGATE PARK LN STE 106",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156911",
            "telephone_number": "423-888-3376",
            "fax_number": "423-870-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSONG DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "SUSONG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-888-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susong Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angelina A Supan, M.D.
• Superior Medical Supply, Inc
• Superior Physical Health Inc
• Alexandrea Leigh Sura, LCSW
• Surgery Center of Chattanooga LP
• Jason Rodney Susong, MD
• Philip Anthony Sutherland, M.D.
• Gregory Ryan Sutton, M.D.
• Harper Sutton
• Jacqueline Sutton

• Dermatology Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.