Chambers, Jodi L

Chambers, Jodi L is an individual health care provider with primary practice located at 3946 Ice Way , Fort Wayne IN 46805-1018. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Chambers, Jodi L can be contacted via phone (260) 266-4007.

Contact Information

Primary practice address
3946 Ice Way Fort Wayne IN 46805-1018
Phone: (260) 266-4007
Fax: (260) 266-4008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10000487A Indiana

Profile Details

NPI number 1487646469
LBN Legal business name Chambers, Jodi L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Oct 12th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487646469 NPPES
Indiana Other 970018667 RAIL ROAD MEDICARE
Indiana MEDICAID 300006248 RAIL ROAD MEDICARE

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