Individual
RONALD BASIL CHISMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTIONER
Contact information
Practice address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-7893
(706) 432-3780
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-7893
(706) 432-3780
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN174288
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606317B
—
GA
Enumeration date
11/17/2011
Last updated
02/06/2013
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