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General NPI Number Information
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NPI Number | 1205375250
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Entity Type | Organization
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Legal Business Name | GENE CHAMBERS PHD PLLC
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 2592 N GREGG AVE STE 16
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5543
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Country | US
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Telephone | 479-313-6333
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Fax | 479-313-6168
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Provider Business Mailing Address
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Address Line | 2592 N GREGG AVE STE 16
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5543
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Country | US
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Telephone | 479-313-6333
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Fax | 479-313-6168
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Authorized Official
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Title or Position | OWNER
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Name | GENE CHAMBERS
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Credential |
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Telephone | 479-313-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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