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Individual

DR. JOHN DUDLEY CHEAPE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1348 WALTON WAY STE 6500, AUGUSTA, GA 30901-5111
(706) 722-2118
(706) 722-0342
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 854-6008
(706) 774-7230

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
036121G
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00538997A
GA
01
2089586
AETNA HMO
GA
01
2648569002
CIGNA
GA
01
2648569003
CIGNA HMO
GA
01
4200328
AETNA
GA
05
G36121
SC
Enumeration date
10/23/2006
Last updated
10/15/2021
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