Individual
JERRY STEPHENS CHASE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 MANCHESTER EXPY, BLD F8, COLUMBUS, GA 31904-6802
(706) 576-5922
(706) 327-4296
Mailing address
2300 MANCHESTER EXPY, BLD F8, COLUMBUS, GA 31904-6802
(706) 576-5922
(706) 327-4296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16037
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00148211C
—
GA
Enumeration date
11/07/2005
Last updated
07/08/2007
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