Provider Demographics
NPI:1083803035
Name:G. STEVEN CHESSER MD PC
Entity Type:Organization
Organization Name:G. STEVEN CHESSER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GLYNN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CHESSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-433-0741
Mailing Address - Street 1:700 SUNSET DR
Mailing Address - Street 2:BLDG 500A SUITE 502
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2293
Mailing Address - Country:US
Mailing Address - Phone:706-433-0741
Mailing Address - Fax:706-433-0746
Practice Address - Street 1:700 SUNSET DR
Practice Address - Street 2:BLDG 500A SUITE 502
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2293
Practice Address - Country:US
Practice Address - Phone:706-433-0741
Practice Address - Fax:706-433-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039307207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11SCFFLOtherMEDICARE PROVIDER NUMBER
GAGRP7225OtherMEDICARE GROUP #
GAGRP7225OtherMEDICARE GROUP #