Healthcare Provider Details

I. General information

NPI: 1871657957
Provider Name (Legal Business Name): GARRETT H CHUMNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 HODGES DR
TALLAHASSEE FL
32308-4614
US

IV. Provider business mailing address

1616 PHYSICIANS DR
TALLAHASSEE FL
32308-4619
US

V. Phone/Fax

Practice location:
  • Phone: 850-431-5741
  • Fax: 850-431-6403
Mailing address:
  • Phone: 850-431-7021
  • Fax: 850-431-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME104106
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME104106
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME104106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: