Provider Demographics
NPI:1023356052
Name:JEAN-GILLES TCHABO MD LTD
Entity type:Organization
Organization Name:JEAN-GILLES TCHABO MD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN GILLES
Authorized Official - Middle Name:
Authorized Official - Last Name:TCHABO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-558-6591
Mailing Address - Street 1:5275 LEE HWY
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-1619
Mailing Address - Country:US
Mailing Address - Phone:703-558-6591
Mailing Address - Fax:703-558-6496
Practice Address - Street 1:5275 LEE HWY
Practice Address - Street 2:SUITE G-1
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-1619
Practice Address - Country:US
Practice Address - Phone:703-558-6591
Practice Address - Fax:703-558-6496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty