Provider Demographics
NPI:1003201260
Name:CHANCELLOR, WILLIAM ZACHARY
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ZACHARY
Last Name:CHANCELLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4017
Mailing Address - Country:US
Mailing Address - Phone:804-320-2751
Mailing Address - Fax:804-330-3831
Practice Address - Street 1:7101 JAHNKE RD STE 500
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4017
Practice Address - Country:US
Practice Address - Phone:804-320-2751
Practice Address - Fax:804-330-3831
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282172208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)