Jacqueline Chan
Pediatric Endocrinologist
1120 15th St
Augusta
, Georgia 30912-7232
Jacqueline Chan
Pediatric Endocrinologist
1120 15th St
Augusta
, Georgia 30912-7232
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About
Features
Specialties
- Pediatric Endocrinologist
Languages spoken
- English
Location
First Address
- Jacqueline Chan
- 1499 Walton Way Ste 1400
- Augusta, GA
- Zip : 30901-2603
- Phone :
Second Address
- Jacqueline Chan
- 1120 15th St
- Augusta, GA
- Zip : 30912-7232
- Phone : (706) 721-8623
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0205X | Pediatric Endocrinologist | 079530 | GA |
National Provider Identifier
| NPI | 1356735914 |
|---|---|
| Provider Name | Jacqueline Chan |
| First Address | Augusta, GA 30901-2603 |
| Second Address | Augusta, GA 30912-7232 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/03/2015 |
| Last Update Date | 08/05/2018 |
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.