Individual
DR. PATRICE GIBSON CHISHOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4112 E PONCE DE LEON AVE, CLARKSTON, GA 30021-8106
(404) 289-7133
(404) 289-7211
Mailing address
4112 E PONCE DE LEON AVE, CLARKSTON, GA 30021-8106
(404) 289-7133
(404) 289-7211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
045185
GA
Other
Enumeration date
07/15/2005
Last updated
03/20/2022
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