Healthcare Provider Details

I. General information

NPI: 1033147228
Provider Name (Legal Business Name): JOHN BERKLEY CHAMBERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 N MARR RD SUITE C
COLUMBUS IN
47201-2610
US

IV. Provider business mailing address

940 N MARR RD SUITE C
COLUMBUS IN
47201-2610
US

V. Phone/Fax

Practice location:
  • Phone: 812-376-9353
  • Fax: 812-376-3757
Mailing address:
  • Phone: 812-376-9353
  • Fax: 812-376-3757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number01049089A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: