Basic Information
| Provider Information | |||||||||
| NPI: | 1497288039 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHATHAM ORTHOPAEDIC ASSOCIATES, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4425 PAULSEN ST | ||||||||
| Address2: | STE 2D | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314053662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123556615 | ||||||||
| FaxNumber: | 9123510645 | ||||||||
| Practice Location | |||||||||
| Address1: | 11702 MERCY BLVD | ||||||||
| Address2: | STE 2D | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314191750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123556615 | ||||||||
| FaxNumber: | 9123510645 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2017 | ||||||||
| LastUpdateDate: | 04/11/2017 | ||||||||
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| AuthorizedOfficialLastName: | HOLTZCLAW | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9123556615 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 35906 | GA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.