# EMORY MEDICAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598926263
- **Authorized official:** CHANDLER MOHAN MD (MANAGING MEMBER)
- **Authorized official phone:** (386) 466-1106

## Contact information

- **Practice address:** 4812 W US HIGHWAY 90, LAKE CITY, FL 32055-5126
- **Practice address phone:** (386) 466-1106
- **Practice address fax:** (386) 466-1821
- **Mailing address:** PO BOX 1646, LAKE CITY, FL 32056-1646
- **Mailing address phone:** (386) 466-1106
- **Mailing address fax:** (386) 466-1821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 0101243179 | VA | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 208D00000X | General Practice Physician | 0101243179 | VA | — |

## Other

- **Enumeration date:** 06/24/2008
- **Last updated:** 03/04/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1598926263 | — | VA |