Provider Demographics
NPI:1912342205
Name:CHILTON SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:CHILTON SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:BINKERD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-280-3248
Mailing Address - Street 1:1006 LAY DAM RD
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35045-2306
Mailing Address - Country:US
Mailing Address - Phone:205-280-3248
Mailing Address - Fax:205-280-3369
Practice Address - Street 1:1911 LAY DAM RD
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-8351
Practice Address - Country:US
Practice Address - Phone:205-280-3248
Practice Address - Fax:205-280-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31935208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL149637Medicaid