MEDICARE: MR. RICK ALLEN CHAMBERLAIN M.D.

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
1	207Q00000X	Family Medicine Physician	01038230A	IN
2	207Q00000X	Family Medicine Physician	35.044870	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	640864	OTHER	IN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1619970704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICK ALLEN CHAMBERLAIN M.D.

Provider Business Mailing Address
First Line	:	3809 WAYCROSS DRIVE
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203
Country	:	US
Telephone Number	:	812-390-0042
Fax Number	:	317-398-1852

Provider Business Practice Location Address
First Line	:	2350 SANDCREST BLVD #D
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203
Country	:	US
Telephone Number	:	812-900-1272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/13/2024

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