Provider Demographics
NPI:1750680104
Name:CHAUDHARI, KAUSHAL SHAMBHUBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:KAUSHAL
Middle Name:SHAMBHUBHAI
Last Name:CHAUDHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4976 ALPHA LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5470
Mailing Address - Country:US
Mailing Address - Phone:423-497-5355
Mailing Address - Fax:423-308-0281
Practice Address - Street 1:3063 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4003
Practice Address - Country:US
Practice Address - Phone:706-841-7274
Practice Address - Fax:706-841-0434
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN51510207Q00000X
GA72196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine