Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Patrice Gibson Chishom, MD

Individual provider Pediatrics Physician · NPI 1366441032

Dr. Patrice Gibson Chishom, MD is a Pediatrics Physician in Clarkston, Georgia. Licensed in Georgia. Registered with an NPI since 2005.

Licensed in
GA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4112 E Ponce De Leon Ave
Clarkston, GA 30021-8106
Phone: (404) 289-7133
Fax: (404) 289-7211
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 045185 (GA)

Record details

NPI number1366441032
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 15, 2005
Last updated in NPPESMarch 20, 2022
Certification dateMarch 20, 2022

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