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General NPI Number Information
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NPI Number | 1780766659
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Entity Type | Individual
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Provider Name | CHESTER ROBERT BADGER JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 1789 ELM ST SUITE A
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City | DUBUQUE
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State | IA
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Zip | 52001-2256
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Country | US
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Telephone | 563-690-2860
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Fax | 563-582-5335
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Provider Business Mailing Address
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Address Line | 1789 ELM ST SUITE A
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City | DUBUQUE
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State | IA
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Zip | 52001-2256
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Country | US
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Telephone | 563-690-2860
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Fax | 563-582-5335
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3765
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License Number State | IA
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