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General NPI Number Information
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NPI Number | 1548320583
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Entity Type | Individual
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Provider Name | DENNIS CHAVES LOURA NP-C
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1401 DESHLER ST SW
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City | FT MCPHERSON
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State | GA
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Zip | 30330-1040
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Country | US
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Telephone | 770-968-6306
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Fax | 678-422-2378
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Provider Business Mailing Address
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Address Line | 588 DIGHTON AVE
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City | TAUNTON
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State | MA
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Zip | 02780-4399
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Country | US
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Telephone | 508-880-9130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 207820
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License Number State | MA
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