Provider Demographics
NPI:1861039950
Name:CHEVALIER, GEORGE JULES IV
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:JULES
Last Name:CHEVALIER
Suffix:IV
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 1:20 HERITAGE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-9148
Mailing Address - Country:US
Mailing Address - Phone:678-616-7151
Mailing Address - Fax:
Practice Address - Street 1:20 HERITAGE POINTE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-9148
Practice Address - Country:US
Practice Address - Phone:678-616-7151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care