Provider Demographics
NPI:1184686594
Name:WILLIAM T. CHAIN, JR., M.D PC
Entity Type:Organization
Organization Name:WILLIAM T. CHAIN, JR., M.D PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHAIN, JR.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-664-7909
Mailing Address - Street 1:327 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1931
Mailing Address - Country:US
Mailing Address - Phone:610-664-7909
Mailing Address - Fax:610-664-7915
Practice Address - Street 1:327 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1931
Practice Address - Country:US
Practice Address - Phone:610-664-7909
Practice Address - Fax:610-664-7915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015337E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA086668YA9Medicare PIN
PA441112245Medicare PIN