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Individual

JACOB CHACHKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
500 E LAUCHWOOD DR, LAURINBURG, NC 28352-5501
(910) 291-7000
Mailing address
PO BOX 409540, ATLANTA, GA 30384-9540

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200301342
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
135NO
BCBS PROVIDER NUMBER
NC
05
PENDING
NC
Enumeration date
07/12/2006
Last updated
07/09/2007
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