DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. PATRICE GIBSON CHISHOM MD

MEDICARE: DR. PATRICE GIBSON CHISHOM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician045185GA

General Provider Information

NPI Number : 1366441032
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICE GIBSON CHISHOM MD
Provider Business Mailing Address
First Line : 4112 E PONCE DE LEON AVE
Second Line :
City : CLARKSTON
State : GA
Zip : 30021-8106
Country : US
Telephone Number : 404-289-7133
Fax Number : 404-289-7211
Provider Business Practice Location Address
First Line : 4112 E PONCE DE LEON AVE
Second Line :
City : CLARKSTON
State : GA
Zip : 30021-8106
Country : US
Telephone Number : 404-289-7133
Fax Number : 404-289-7211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 03/20/2022

Similar Medicare Providers

1285621037 — DR. STEPHANIE M HENRY MD
Practice Location Address:
4112 E PONCE DE LEON AVE
CLARKSTON, GA
30021-8106
Practice Phone: 404-296-7133
Practice Fax: 404-296-7211
1922063734 — TRACY FERGUSON M.D.
Practice Location Address:
4112 E PONCE DE LEON AVE
CLARKSTON, GA
30021-8106
Practice Phone: 404-296-7133
Practice Fax: 404-296-7211
1962579631 — KEANNA L JOSEPH-CLARKE MD
Practice Location Address:
4112 E PONCE DE LEON AVE
CLARKSTON, GA
30021-8106
Practice Phone: 404-296-7133
Practice Fax: 404-296-7211
1497277404 — KIDS-DOC-ON-WHEELS
Practice Location Address:
4112 E PONCE DE LEON AVE # 2
CLARKSTON, GA
30021-8106
Practice Phone: 404-574-2512
Practice Fax: 404-296-7211
1376106534 — PREETHI RAJAN
Practice Location Address:
4112 E PONCE DE LEON AVE
CLARKSTON, GA
30021-8106
Practice Phone: 404-296-7133
Practice Fax:
1285278739 — MRS. EMILY SCHOBER KLINGMAN NP
Practice Location Address:
4112 E PONCE DE LEON AVE
CLARKSTON, GA
30021-8106
Practice Phone: 318-455-1870
Practice Fax:

Directions to “ DR. PATRICE GIBSON CHISHOM MD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.