Chan, John

Chan, John is an sole proprietor health care provider with primary practice located at 2140 Smith St , Orange Park FL 32073-5554. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Chan, John can be contacted via phone (904) 269-2140.

Contact Information

Primary practice address
2140 Smith St Orange Park FL 32073-5554
Phone: (904) 269-2140
Fax: (904) 264-3018
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101246006 Virginia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME 123976 Florida

Profile Details

NPI number 1013178433
LBN Legal business name Chan, John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2008
Last updated Dec 24th, 2018 - about 7 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 1013178433 NPPES
Florida MEDICAID 016263600

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