Provider Demographics
NPI:1093389041
Name:ROHRBAUGH, CHANCE KENNETH
Entity Type:Individual
Prefix:
First Name:CHANCE
Middle Name:KENNETH
Last Name:ROHRBAUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL EDUCATION OFFICE, 1700 ST. LUKE'S BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045
Mailing Address - Country:US
Mailing Address - Phone:484-526-1000
Mailing Address - Fax:
Practice Address - Street 1:1872 ST LUKE'S BLVD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5669
Practice Address - Country:US
Practice Address - Phone:484-526-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT020561207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine