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NPI Code Detail

MEDICARE: NICHOLAS S CHAMBERLAIN OD

MEDICARE:   NICHOLAS S CHAMBERLAIN  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristM727MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356492946
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS S CHAMBERLAIN OD
Provider Business Mailing Address
First Line : 100 WESTVIEW PARK PL
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3074
Country : US
Telephone Number : 406-755-5910
Fax Number : 406-756-5701
Provider Business Practice Location Address
First Line : 580 N MERIDIAN RD
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3074
Country : US
Telephone Number : 406-755-5910
Fax Number : 406-756-5701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/19/2019

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Directions to “ NICHOLAS S CHAMBERLAIN OD” Practice Location

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