Provider Demographics
NPI:1346270592
Name:CHANEY, JOHN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:CHANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 MAR WALT DRIVE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547
Mailing Address - Country:US
Mailing Address - Phone:850-243-0118
Mailing Address - Fax:850-243-0594
Practice Address - Street 1:1005 MAR WALT DRIVE
Practice Address - Street 2:PULMONOLOGY DEPARTMENT
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6707
Practice Address - Country:US
Practice Address - Phone:850-243-0118
Practice Address - Fax:850-243-0594
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97823207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278143300Medicaid
FL96334OtherBCBSFL
FL278143300Medicaid