Provider Demographics
NPI:1568744951
Name:CHESTNUT OAK EMERGENCY PHYSICIANS LLC
Entity Type:Organization
Organization Name:CHESTNUT OAK EMERGENCY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:R
Authorized Official - Last Name:RONAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-401-2386
Mailing Address - Street 1:13737 NOEL ROAD
Mailing Address - Street 2:STE 1600
Mailing Address - City:CLEARWATER
Mailing Address - State:TX
Mailing Address - Zip Code:33764-6576
Mailing Address - Country:US
Mailing Address - Phone:469-401-2386
Mailing Address - Fax:214-712-2444
Practice Address - Street 1:1700 MEDICAL WAY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2195
Practice Address - Country:US
Practice Address - Phone:770-979-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty