Chan, J. Jack
Chan, J. Jack is an individual health care provider with primary practice located at 86 Columbus Rd Ste 203, Athens OH 45701-1331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Chan, J. Jack can be contacted via phone (740) 594-2624.Contact Information
Primary practice address
86 Columbus Rd Ste 203
Athens OH 45701-1331
Phone: (740) 594-2624
Fax: (740) 594-7333
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 34005890 | Ohio |
Profile Details
| NPI number | 1053314245 |
|---|---|
| LBN Legal business name | Chan, J. Jack |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | May 19th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053314245 | NPPES |
| Ohio | MEDICAID | 0956881 |
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