Provider Demographics
NPI:1326017856
Name:CHAUVIN, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:CHAUVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 44004
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4004
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-348-5627
Practice Address - Street 1:820 PRUDENTIAL DR STE 304
Practice Address - Street 2:CREDENTIALING DEPARTMENT
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8205
Practice Address - Country:US
Practice Address - Phone:904-348-0974
Practice Address - Fax:904-348-5627
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNME14068207R00000X
FLME121819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0135972-00Medicaid
B04492Medicare UPIN
FLIA215ZMedicare PIN
B04492Medicare UPIN
FLIA215ZMedicare PIN
TNP00379440OtherRAILROAD MEDICARE