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General NPI Number Information
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NPI Number | 1538485040
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Entity Type | Individual
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Provider Name | BILLY GEROME CHANCEY PARAMEDIC
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Gender | Male
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | BLDG 8450 2ND AVE
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City | FT. RUCKER
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State | AL
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Zip | 36362
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Country | US
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Telephone | 334-255-3570
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Fax |
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Provider Business Mailing Address
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Address Line | 4 S WISE ST
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City | SAMSON
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State | AL
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Zip | 36477-1339
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Country | US
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Telephone | 334-726-1623
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 9701224
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License Number State | AL
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