Healthcare Provider Details

I. General information

NPI: 1558867457
Provider Name (Legal Business Name): CHELSEA ELIZABETH DONATHAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 N 3RD AVE
CHATSWORTH GA
30705-2118
US

IV. Provider business mailing address

165 BLUE RIDGE OVERLOOK
BLUE RIDGE GA
30513-4431
US

V. Phone/Fax

Practice location:
  • Phone: 706-517-2273
  • Fax: 706-517-2469
Mailing address:
  • Phone: 706-946-5607
  • Fax: 706-374-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number111102
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number111102
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: