Provider Demographics
NPI:1427497825
Name:CHAO, JONATHAN DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:CHAO
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:5947 HOLLY SPRINGS PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2449
Mailing Address - Country:US
Mailing Address - Phone:404-556-7656
Mailing Address - Fax:
Practice Address - Street 1:915 RIDGEWALK PKWY STE 425
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-0119
Practice Address - Country:US
Practice Address - Phone:770-592-7413
Practice Address - Fax:770-516-6797
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAOPT002756152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist