Provider Demographics
NPI:1982819728
Name:CHATHAM, REBECCA P (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:P
Last Name:CHATHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1213
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-1213
Mailing Address - Country:US
Mailing Address - Phone:859-236-2425
Mailing Address - Fax:859-236-2292
Practice Address - Street 1:120 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1870
Practice Address - Country:US
Practice Address - Phone:859-236-2425
Practice Address - Fax:859-236-9776
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY40231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine