=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356532717
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. NEWTON J CHALKER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2007
-----------------------------------------------------
Last Update Date | 08/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PSC 827 BOX 225
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | CASERTA
-----------------------------------------------------
Zip | AE
-----------------------------------------------------
Country | IT
-----------------------------------------------------
Telephone | 6295990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PSC 827 BOX 225
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | CASERTA
-----------------------------------------------------
Zip | AE
-----------------------------------------------------
Country | IT
-----------------------------------------------------
Telephone | 6295990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 041309199
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------