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General NPI Number Information
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NPI Number | 1164435277
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Entity Type | Organization
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Legal Business Name | JOHN R. CHEWNING DO PA
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 02/14/2014
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Provider Practice Location Address
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Address Line | 1425 HAND AVE, SUITE L
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-256-3977
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Fax | 386-872-5004
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Provider Business Mailing Address
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Address Line | 1425 HAND AVENUE, SUITE L
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-256-3977
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Fax | 386-872-5004
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JOHN ROY CHEWNING
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Credential | DO
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Telephone | 386-256-3977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8215
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License Number State | FL
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