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General NPI Number Information
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NPI Number | 1821232406
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Entity Type | Organization
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Legal Business Name | BRMS OB/GYN
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | 159 INTERSTATE PKWY
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City | BRADFORD
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State | PA
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Zip | 16701-1013
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Country | US
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Telephone | 814-368-3123
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Fax |
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Provider Business Mailing Address
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Address Line | 116 INTERSTATE PKWY
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City | BRADFORD
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State | PA
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Zip | 16701-1036
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Country | US
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Telephone | 814-368-3123
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PRACTICE MANAGEMENT
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Name | RHONDA K CHILSON
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Credential | RN
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Telephone | 814-362-8277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD024058E
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License Number State | PA
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