J. JACK CHAN (NPI# 1053314245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053314245 |
| Entity Type | Individual |
| Full Name | J. JACK CHAN |
| Credential | D.O. |
| Practice Address |
86 Columbus Rd Ste 203 Athens OH 45701-1331 |
| Mailing Address |
86 Columbus Rd Suite 203 Athens OH 45701-1300 |
| Practice Telephone | 7405942624 |
| Practice Fax Number | 7405947333 |
| Mailing Telephone | 7405942624 |
| Mailing Fax Number | 7405947333 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 34005890 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0956881 | 05 |
| Street Address |
86 COLUMBUS RD STE 203 |
| City | ATHENS |
| State | OH |
| Zip Code | 45701-1331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497003 | Michael Visintainer | Counselor | 86 Columbus Rd, Athens, OH 45701-1300 | 2020-11-04 |
| 1285143230 | Shawn Lee Drescher | Counselor | 86 Columbus Rd, Athens, OH 45701-1300 | 2017-09-21 |
| 1699037127 | Emily Ruth Elliott | Physical Therapy Assistant | 86 Columbus Rd, Suite 203, Athens, OH 45701-1300 | 2012-06-11 |
| 1760471288 | Pamela R Scholl | Nurse Practitioner | 86 Columbus Rd, Ste 203, Athens, OH 45701 | 2005-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508797 | Vince R Koping | Pharmacist | 929 East State St, Athens, OH 45701 | 2020-11-06 |
| 1164051926 | Rachel Staker | Student in an Organized Health Care Education/Training Program | 86 Circle Drive, Suite 203, Athens, OH 45701 | 2020-04-03 |
| 1932736709 | Maria Augusta Suarez-hamman | Student in an Organized Health Care Education/Training Program | 86 Columbus Circle, Suite 203, Athens, OH 45701 | 2020-03-23 |
| 1831746882 | Justin Joseph Moakler | Specialist/Technologist | Ohio University Athens Training Facility, Grover Center E 187, Athens, OH 45701 | 2019-08-23 |
| 1275186991 | Barry Brady | Psychologist | Hudson Health Center, 3rd Floor 1 Ohio University, Athens, OH 45701 | 2019-07-22 |
| 1821559691 | Mary N Lee | Student in an Organized Health Care Education/Training Program | 1 Ohio Univerisity Dept of Psychology, Porter Hall Room 002, Athens, OH 45701 | 2019-03-26 |
| 1275007692 | Gabrielle Ruth Wesemeyer | Student in an Organized Health Care Education/Training Program | 6 South Congress Street, Athens, OH 45701 | 2019-01-18 |
| 1528551918 | Bradford Thomas Meyers | Psychologist | 1 University Ave, Ohio University, Athens, Oh 45701, Athens, OH 45701 | 2018-06-11 |
| 1912499344 | William Monopoli | Student in an Organized Health Care Education/Training Program | 1 Ohio University Department of Psychology, Porter Hall Room 002, Athens, OH 45701 | 2018-06-01 |
| 1477044113 | 59 Green Ltd. | Taxi | 14 Cook Drive, Athens, OH 45701 | 2018-05-29 |
| Find all providers in zip 45701 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235770876 | George Vasilios Kontopoulos | Obstetrics & Gynecology | 8 Agisilaou St, Athens, NONE 15123 | 2019-10-04 |
| 1588026660 | Elizabeth Garcia-cardenas | Obstetrics & Gynecology | 242 King Ave Ste 120, Athens, GA 30606 | 2016-03-28 |
| 1275803389 | John Bunn Hill | Obstetrics & Gynecology | 740 Prince Ave Ste 3, Athens, GA 30606-5903 | 2012-01-05 |
| 1750516621 | Linda S Ross | Obstetrics & Gynecology | 75 Hospital Dr Ste 260, Athens, OH 45701-2866 | 2009-05-21 |
| 1639311640 | Stephen Robert Shassberger | Obstetrics & Gynecology | 22335 Us Highway 72 Ste C, Athens, AL 35613-2611 | 2009-04-06 |
| 1689854614 | Gregory F. Mondini | Obstetrics & Gynecology | 607 E Clinton Ave, Athens, TX 75751-3411 | 2007-11-07 |
| 1336108620 | Rajiv Dinkar Desai | Obstetrics & Gynecology | 1500 Oglethorpe Avenue, Building 500 Suite D, Athens, GA 30606-2184 | 2006-03-23 |
| 1710952262 | Clinton B Ashford | Obstetrics & Gynecology | 1750 S Lumpkin St, Athens, GA 30606-4739 | 2006-02-20 |
| 1588638126 | Gregory F Mondini Md Pa | Obstetrics & Gynecology | 607 East Clinton, Athens, TX 75751 | 2006-02-13 |
| 1134120256 | Mark L Eldore | Obstetrics & Gynecology | 824 Southpark Circle, Athens, TX 75752 | 2005-08-10 |
| Find all providers in ATHENS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.