Provider Demographics
NPI:1801181409
Name:CHAFFIN, JAMES THEODORE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THEODORE
Last Name:CHAFFIN
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3334
Mailing Address - Country:US
Mailing Address - Phone:706-548-8656
Mailing Address - Fax:706-548-8656
Practice Address - Street 1:3065 ATLANTA HWY
Practice Address - Street 2:T1453
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3334
Practice Address - Country:US
Practice Address - Phone:706-548-8656
Practice Address - Fax:706-548-8656
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH010491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist