Ko, Song-Chu

Ko, Song-Chu is an individual health care provider with primary practice located at 308 Coliseum Dr Ste 100 , Macon GA 31217-3889. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Ko, Song-Chu can be contacted via phone (478) 742-2278.

Contact Information

Primary practice address
308 Coliseum Dr Ste 100 Macon GA 31217-3889
Phone: (478) 742-2278
Fax: (671) 645-5549
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 01061833A Indiana
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X M-1915 Guam
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 99225 Georgia

Profile Details

NPI number 1740205921
LBN Legal business name Ko, Song-Chu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated May 29th, 2024 - about 2 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 1740205921 NPPES
Indiana Other 000000711556 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 200826200 ANTHEM PROVIDER NUMBER

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