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Individual

KAZUMI CHINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
800 1ST ST STE 110, MACON, GA 31201-8306
(478) 743-3466
(478) 746-2049
Mailing address
800 1ST ST STE 110, MACON, GA 31201-8306
(478) 743-3466
(787) 462-0494

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
01066492A
IN
2085R0001X
Radiation Oncology Physician
72755
AZ
2085R0001X
Radiation Oncology Physician
Primary
82624
GA
2085R0001X
Radiation Oncology Physician
ME125656
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000618824
ANTHEM PIN
IN
05
003219046A
GA
05
015771800
FL
05
200952470
IN
01
P01564915
RAILROAD MEDICARE PTAN
FL
Enumeration date
05/23/2007
Last updated
07/26/2023
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