Provider Demographics
NPI:1366481285
Name:CHESTER COUNTY ORTHOPAEDIC ASSOCIATES,LTD
Entity Type:Organization
Organization Name:CHESTER COUNTY ORTHOPAEDIC ASSOCIATES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BENNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-692-6280
Mailing Address - Street 1:915 OLD FERN HILL RD
Mailing Address - Street 2:SUITE 1 B-A
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4269
Mailing Address - Country:US
Mailing Address - Phone:610-350-2210
Mailing Address - Fax:610-429-1943
Practice Address - Street 1:915 OLD FERN HILL RD
Practice Address - Street 2:SUITE 1 B-A
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4269
Practice Address - Country:US
Practice Address - Phone:610-350-2210
Practice Address - Fax:610-429-1943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015661Medicaid
20700Medicare PIN
PA1015661Medicaid