Provider Demographics
NPI:1407843634
Name:CHAMBERS, RONALD ERNEST (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ERNEST
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4328
Mailing Address - Country:US
Mailing Address - Phone:423-245-6189
Mailing Address - Fax:423-378-4837
Practice Address - Street 1:205 E SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4328
Practice Address - Country:US
Practice Address - Phone:423-245-6189
Practice Address - Fax:423-378-4837
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3671545Medicaid
T74793Medicare UPIN
TN3671545Medicaid