Provider Demographics
NPI:1639334881
Name:CHAFIN, JOHN MICHAEL I
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:CHAFIN
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1442
Mailing Address - Country:US
Mailing Address - Phone:404-366-4320
Mailing Address - Fax:404-366-0834
Practice Address - Street 1:1032 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1442
Practice Address - Country:US
Practice Address - Phone:404-366-4320
Practice Address - Fax:404-366-0834
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA113771835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAFLU336Medicare UPIN