1164437695 NPI number — F. DAVID CHAMBERS, M.D. PA

Table of content: (NPI 1164437695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164437695 NPI number — F. DAVID CHAMBERS, M.D. PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
F. DAVID CHAMBERS, M.D. PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164437695
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 ROBINWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUMAS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71639-2832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-866-2509
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
811 HIGHWAY 65 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUMAS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71639-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-382-8261
Provider Business Practice Location Address Fax Number:
870-382-8146
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHAMBERS
Authorized Official First Name:
FRANKLIN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
MEDICAL DOCTOR
Authorized Official Telephone Number:
870-866-2509

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  C5780 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110000353 . This is a "MEDICARE RAILROAD #" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 101337001 INDIVIDUAL , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 135240000 . This is a "QUAL CHOICE PROVIDER#" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 146304002 GROUP # , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 146304002 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50958 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com