Provider Demographics
NPI:1972547263
Name:CHAMBERLAIN, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-2387
Mailing Address - Country:US
Mailing Address - Phone:859-744-0016
Mailing Address - Fax:859-744-0137
Practice Address - Street 1:2570 BYPASS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2387
Practice Address - Country:US
Practice Address - Phone:859-744-0016
Practice Address - Fax:859-744-0137
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31990207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64319908Medicaid
KY000000051581OtherANTHEM
KY64319908Medicaid
KY0906601Medicare PIN