Provider Demographics
NPI:1285153866
Name:KOKAR, CHATCHAI (MD)
Entity type:Individual
Prefix:
First Name:CHATCHAI
Middle Name:
Last Name:KOKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 MAIN ST
Mailing Address - Street 2:STE 207
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3640 MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1192
Practice Address - Country:US
Practice Address - Phone:413-739-0669
Practice Address - Fax:413-739-0621
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA284387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine