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Organization
EMORY MEDICAL CORPORATION
Active
Organization
EMORY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDLER MOHAN MD (MANAGING MEMBER)
(386) 466-1106
Entity
Organization
Contact information
Practice address
4812 W US HIGHWAY 90, LAKE CITY, FL 32055-5126
(386) 466-1106
(386) 466-1821
Mailing address
PO BOX 1646, LAKE CITY, FL 32056-1646
(386) 466-1106
(386) 466-1821
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101243179
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208D00000X
General Practice Physician
0101243179
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598926263
—
VA
Enumeration date
06/24/2008
Last updated
03/04/2020
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