Provider Demographics
NPI:1902010754
Name:GEORGE P CHATSON MD, PC
Entity Type:Organization
Organization Name:GEORGE P CHATSON MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-687-1151
Mailing Address - Street 1:555 TURNPIKE ST
Mailing Address - Street 2:SUITE 52
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5923
Mailing Address - Country:US
Mailing Address - Phone:978-687-1151
Mailing Address - Fax:978-687-1567
Practice Address - Street 1:555 TURNPIKE ST
Practice Address - Street 2:SUITE 52
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5923
Practice Address - Country:US
Practice Address - Phone:978-687-1151
Practice Address - Fax:978-687-1567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79491174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0005523Medicare PIN
MAJ30463Medicare PIN