Provider Demographics
NPI:1790725562
Name:FALCHOOK, FREDERICK STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:STEVEN
Last Name:FALCHOOK
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 1:116 INTRACOASTAL POINTE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5024
Mailing Address - Country:US
Mailing Address - Phone:561-744-9122
Mailing Address - Fax:
Practice Address - Street 1:1850 N COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2385
Practice Address - Country:US
Practice Address - Phone:478-453-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0363732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA036373OtherSTATE LICENSE #
GA00544794CMedicaid
GA00544794CMedicaid
GA511G700001Medicare PIN
GA511I300067Medicare PIN