Provider Demographics
NPI:1023420197
Name:CHOKSY, VAIRAGI
Entity type:Individual
Prefix:
First Name:VAIRAGI
Middle Name:
Last Name:CHOKSY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VAIRAGI
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:811 13TH ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2700
Mailing Address - Country:US
Mailing Address - Phone:706-434-1590
Mailing Address - Fax:
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2700
Practice Address - Country:US
Practice Address - Phone:706-434-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7145363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical