Roy Chu, M.D.
Individual provider Active NPI Surgery Physician · Jasper, GA
NPI 1467414359 · NPPES record last updated May 22, 2008
Key facts
- NPI
- 1467414359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 052542 (GA)
- Practice address
- 80 Interstate South Dr
Ste B
Jasper, GA 30143-6226 - Phone
- (706) 692-9081
- Fax
- (706) 692-0155
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052542 | GA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northside Surgical Associate | Surgery | Past | Accepting new patients |
| Piedmont Providers LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 052542 | GA | Yes |
Addresses
Primary practice location
80 Interstate South Dr
Ste B
Jasper, GA 30143-6226
Mailing address
80 Interstate South Dr
Ste B
Jasper, GA 30143-6226
Phone (706) 692-9081
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562466025A | Medicaid | GA |
Other providers in Jasper, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.