Hollace D Chastain
Interventional Cardiology Internist - Cardiovascular Disease
11108 Parkview Circle Dr
Fort Wayne
, Indiana 46845-1730
Hollace D Chastain
Interventional Cardiology Internist - Cardiovascular Disease
11108 Parkview Circle Dr
Fort Wayne
, Indiana 46845-1730
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- Hollace D Chastain
- 11109 Parkview Plaza Dr # 117
- Fort Wayne, IN
- Zip : 46845-1701
- Phone :
Second Address
- Hollace D Chastain
- 11108 Parkview Circle Dr
- Fort Wayne, IN
- Zip : 46845-1730
- Fax : (260) 266-5920
- Phone : (260) 266-5700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0000X | Internist - Cardiovascular Disease | 01039775A | IN |
| Y | 207RI0011X | Interventional Cardiology | 01039775A | IN |
National Provider Identifier
| NPI | 1013919422 |
|---|---|
| Provider Name | Hollace D Chastain |
| First Address | Fort Wayne, IN 46845-1701 |
| Second Address | Fort Wayne, IN 46845-1730 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/08/2005 |
| Last Update Date | 12/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000641068 | ANTHEM (01) | IN |
| 060070569 | RR MEDICARE (01) | IN |
| 200322020 | (05) | IN |
| 2232319 | (05) | OH |
| H32747 | (02) | IN |
| P00786816 | R.R. MEDICARE (01) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.