Provider Demographics
NPI:1679542849
Name:CHESSER, G STEVEN JR (M D)
Entity Type:Individual
Prefix:DR
First Name:G STEVEN
Middle Name:
Last Name:CHESSER
Suffix:JR
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 OLD JEFFERSON RD BLDG 700
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1465
Mailing Address - Country:US
Mailing Address - Phone:706-353-2990
Mailing Address - Fax:706-353-4352
Practice Address - Street 1:3320 OLD JEFFERSON ROAD, BLDG 600
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607
Practice Address - Country:US
Practice Address - Phone:706-353-2990
Practice Address - Fax:706-353-4352
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
GA39307207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000709728IMedicaid
GA11SCFFLMedicare ID - Type Unspecified
GA000709728DMedicaid