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Individual

NEWTON W CHISM JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2400 BELLEVUE RD, #23 ERIN OFFICE PARK, DUBLIN, GA 31021-2885
(478) 272-8580
(478) 275-0012
Mailing address
2400 BELLEVUE RD, STE 23, DUBLIN, GA 31021-2888
(478) 272-8580
(478) 275-0012

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
017442
GA
2084P0800X
Psychiatry Physician
017442
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00082233A
GA
05
300030912A
GA
Enumeration date
06/07/2006
Last updated
02/01/2021
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