Healthcare Provider Details

I. General information

NPI: 1366481285
Provider Name (Legal Business Name): CHESTER COUNTY ORTHOPAEDIC ASSOCIATES,LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD SUITE 1 B-A
WEST CHESTER PA
19380-4269
US

IV. Provider business mailing address

915 OLD FERN HILL RD SUITE 1 B-A
WEST CHESTER PA
19380-4269
US

V. Phone/Fax

Practice location:
  • Phone: 610-350-2210
  • Fax: 610-429-1943
Mailing address:
  • Phone: 610-350-2210
  • Fax: 610-429-1943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN H BENNER
Title or Position: PRESIDENT
Credential: MD
Phone: 610-692-6280