Chalut, Carissa Leigh

Chalut, Carissa Leigh is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Chalut, Carissa Leigh can be contacted via phone (706) 721-2613.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Phone: (706) 721-2613
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X R9196 Texas
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 6812 Georgia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OP61130040 Washington

Profile Details

NPI number 1801201413
LBN Legal business name Chalut, Carissa Leigh
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2014
Last updated Dec 6th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801201413 NPPES
Georgia MEDICAID 56647-95

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