Individual
LEE CHISOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 OGLETHORPE AVE, SUITE 3300, ATHENS, GA 30606-2179
(706) 208-1406
(706) 208-1407
Mailing address
1500 OGLETHORPE AVE, SUITE 3300, ATHENS, GA 30606-2179
(706) 208-1406
(706) 208-1407
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55115
GA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
055115
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
648462505A
—
GA
Enumeration date
09/02/2006
Last updated
09/22/2016
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