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General NPI Number Information
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NPI Number | 1902009095
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Entity Type | Individual
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Provider Name | JAMES GEORGE CHAMBERS IV M.D., PHD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 1404 RIVER PL SUITE 201
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City | BRASELTON
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State | GA
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Zip | 30517-5600
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Country | US
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Telephone | 770-219-9200
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Fax | 770-219-9273
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Provider Business Mailing Address
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Address Line | 1404 RIVER PL SUITE 201
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City | BRASELTON
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State | GA
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Zip | 30517-5600
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Country | US
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Telephone | 770-219-9200
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Fax | 770-219-9273
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD48504
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 073718
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License Number State | GA
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