Provider Demographics
NPI:1548585813
Name:JEFFREY R. CHAMBERS, M.D., P.A.
Entity Type:Organization
Organization Name:JEFFREY R. CHAMBERS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:919-490-9787
Mailing Address - Street 1:3308 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE 131
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2694
Mailing Address - Country:US
Mailing Address - Phone:919-490-9787
Mailing Address - Fax:919-490-3099
Practice Address - Street 1:3308 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 131
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2694
Practice Address - Country:US
Practice Address - Phone:919-490-9787
Practice Address - Fax:919-490-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC317862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC21899OtherBCBS
NC8921899Medicaid
NC8921899Medicaid