Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 28728 | CO |
N | 208600000X | Surgeon | 28728 | CO |
Y | 2086S0129X | Vascular Surgeon | 28728 | CO |
NPI | 1083689913 |
---|---|
Provider Name | Dr. William C Chambers JR. |
First Address | Colorado Springs, CO 80907-6831 |
Second Address | Colorado Springs, CO 80907-6831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 02/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01287283 | (05) | CO |
020018127 | RAILROAD MEDICARE NUMBER (01) | |
4515748 | AETNA PIN (01) | |
C14342 | (02) | |
CHD1848 | BLUE SHIELD NUMBER (01) |