Individual
JODI LYNN CHITWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
35 COLLIER RD NW, SUITE 500, ATLANTA, GA 30309-1613
(404) 350-1010
(404) 355-7338
Mailing address
35 COLLIER RD NW, SUITE 500, ATLANTA, GA 30309-1613
(404) 350-1010
(404) 355-7338
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053118
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215105
BLUE CROSS BLUE SHIELD
GA
01
—
582001048
TAX I.D.
GA
01
—
5820010480000E
FED I.D.
GA
Enumeration date
12/19/2006
Last updated
07/08/2007
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