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General NPI Number Information
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NPI Number | 1598311466
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Entity Type | Individual
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Provider Name | YEIMI ORTIZ-CHAVEZ
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 1102 W WAUGH ST
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City | DALTON
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State | GA
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Zip | 30720-8769
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Country | US
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Telephone | 106-277-2321
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Fax |
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Provider Business Mailing Address
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Address Line | 625 OLD PEACHTREE RD NW
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City | SUWANEE
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State | GA
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Zip | 30024-2937
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 10094
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License Number State | GA
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