Provider Demographics
NPI:1427219989
Name:CHO, SUNG ROCK (MD)
Entity Type:Individual
Prefix:
First Name:SUNG
Middle Name:ROCK
Last Name:CHO
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:PO BOX 12938
Mailing Address - Street 2:C/O CLINIC MANAGEMENT
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703
Mailing Address - Country:US
Mailing Address - Phone:706-602-7800
Mailing Address - Fax:706-624-5072
Practice Address - Street 1:110 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2079
Practice Address - Country:US
Practice Address - Phone:706-624-5071
Practice Address - Fax:706-624-5072
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2055712081P2900X
TN496932081P2900X
GA0763192081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003177901AMedicaid