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Individual

DR. JOHN T CHACKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3051 6TH ST, MARIANNA, FL 32446-1933
(850) 526-0005
(850) 718-4261
Mailing address
1752 SW 1ST AVE, OCALA, FL 34471-8170
(850) 526-0005
(850) 718-4261

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME74735
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
42842
BCBSFL
FL
Enumeration date
07/24/2006
Last updated
05/09/2016
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