Provider Demographics
NPI:1346298213
Name:CHOAT, DENNIS E (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:E
Last Name:CHOAT
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 1:1260 HIGHWAY 54 W
Mailing Address - Street 2:STE 100
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4514
Mailing Address - Country:US
Mailing Address - Phone:770-277-4277
Mailing Address - Fax:770-716-8690
Practice Address - Street 1:1265 HIGHWAY 54 W STE 500B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4556
Practice Address - Country:US
Practice Address - Phone:770-719-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039069208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000779798GMedicaid
2064OtherKAISER
5890788OtherAETNA NON HMO
1452874OtherUNITED HEALTHCARE
6665545007OtherCIGNA HMO
AL009936605Medicaid
2187122OtherAETNA HMO
GA00779798AMedicaid
52664848OtherBCBS
6665545007OtherCIGNA HMO
1452874OtherUNITED HEALTHCARE
6665545007OtherCIGNA HMO