Provider Demographics
NPI:1215110358
Name:CHAMBERLAND ORTHOPAEDICS PC
Entity type:Organization
Organization Name:CHAMBERLAND ORTHOPAEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:CHAMBERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-641-4355
Mailing Address - Street 1:711 N TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2243
Mailing Address - Country:US
Mailing Address - Phone:970-641-4355
Mailing Address - Fax:970-641-0377
Practice Address - Street 1:711 N TAYLOR ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2243
Practice Address - Country:US
Practice Address - Phone:970-641-4355
Practice Address - Fax:970-641-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33603207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1215110358OtherANTHEM BLUE CROSS
CO01336031Medicaid
CO01336031Medicaid
COC321708Medicare PIN
CO1005320001Medicare NSC