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NPI Code Detail

MEDICARE: PRESTON CHANDLER DELAPERRIERE M.D.

MEDICARE: PRESTON CHANDLER DELAPERRIERE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician36365GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699756361
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRESTON CHANDLER DELAPERRIERE M.D.
Provider Business Mailing Address
First Line : 3356 VINEVILLE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2328
Country : US
Telephone Number : 478-476-9642
Fax Number : 478-476-9976
Provider Business Practice Location Address
First Line : 3356 VINEVILLE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2328
Country : US
Telephone Number : 478-476-9642
Fax Number : 478-476-9976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 04/23/2013

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Directions to “ PRESTON CHANDLER DELAPERRIERE M.D.” Practice Location

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