Organization
J CALVIN CHATLOS MD LLC
Active
Other names
JOHN C CHATLOS MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CALVIN CHATLOS JR. MD (SOLE PROPRIETOR)
(732) 414-6001
Entity
Organization
Contact information
Practice address
400 W MAIN ST, FREEHOLD, NJ 07728-2529
(732) 414-6001
(732) 677-3149
Mailing address
400 W MAIN ST, FREEHOLD, NJ 07728-2529
(732) 414-6001
(732) 677-3149
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
MA 46262
NJ
2084P0800X
Psychiatry Physician
Primary
MA 46262
NJ
2084P0802X
Addiction Psychiatry Physician
MA 46262
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
MA 46262
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2508206
—
NJ
Enumeration date
10/16/2009
Last updated
10/16/2009
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