Provider Demographics
NPI:1659072916
Name:CHAVEZ, FRANK A
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:CHAVEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MCGOWAN RD APT J103
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7703
Mailing Address - Country:US
Mailing Address - Phone:678-849-3505
Mailing Address - Fax:
Practice Address - Street 1:823 S CHURCH ST APT 4104
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4737
Practice Address - Country:US
Practice Address - Phone:678-849-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL92581208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery