Healthcare Provider Details

I. General information

NPI: 1083689913
Provider Name (Legal Business Name): WILLIAM C CHAMBERS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE SUITE 5017
COLORADO SPRINGS CO
80907-6831
US

IV. Provider business mailing address

2222 N NEVADA AVE SUITE 5017
COLORADO SPRINGS CO
80907-6831
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-2501
  • Fax: 719-632-1062
Mailing address:
  • Phone: 719-635-2501
  • Fax: 719-632-1062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number28728
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number28728
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: