Chabolla, David Roger

Chabolla, David Roger is an individual health care provider with primary practice located at 4205 Belfort Rd Ste 1100 , Jacksonville FL 32216-5876. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Chabolla, David Roger can be contacted via phone (904) 450-6300.

Contact Information

Primary practice address
4205 Belfort Rd Ste 1100 Jacksonville FL 32216-5876
Phone: (904) 450-6300
Fax: (904) 281-5966
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X ME68656 Florida

Profile Details

NPI number 1245229319
LBN Legal business name Chabolla, David Roger
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Jul 29th, 2019 - 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 1245229319 NPPES
Florida Other 130012335 RAILROAD MEDICARE
Florida Other 27473 RAILROAD MEDICARE
Florida MEDICAID 268609100 RAILROAD MEDICARE

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