Provider Demographics
NPI:1316197205
Name:CHAMBERS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:CHAMBERS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:JOSEPH C. ECKERT D.O/PRESIDENT/OWNE
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CONRAD
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-831-2600
Mailing Address - Street 1:3533 DUNN RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033
Mailing Address - Country:US
Mailing Address - Phone:314-831-2600
Mailing Address - Fax:314-831-5393
Practice Address - Street 1:3533 DUNN RD
Practice Address - Street 2:SUITE 204
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033
Practice Address - Country:US
Practice Address - Phone:314-831-2600
Practice Address - Fax:314-831-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000009016Medicare Oscar/Certification
D41718Medicare UPIN