Individual
DR. JACOB CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2055 W HOSPITAL DR STE 205, TUCSON, AZ 85704-7822
(520) 575-6944
(520) 575-1115
Mailing address
PO BOX 13627, TUCSON, AZ 85732-3627
(520) 575-6944
(520) 575-1115
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
26484
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z5260
HEALTHNET
AZ
05
—
509961
—
AZ
01
—
AZ0874840
BCBS
AZ
Enumeration date
09/25/2006
Last updated
11/18/2024
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