Organization
CHATHAM FACIAL PLASTIC SURGERY LLC
Active
Other names
Dr. Donn R. Chatham
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAYTH BREEDING (OFFICE MANAGER)
(812) 945-3223
Entity
Organization
Contact information
Practice address
1919 STATE STREET, SUITE 144, NEW ALBANY, IN 47150
(812) 945-3223
Mailing address
1919 STATE ST, SUITE 144, NEW ALBANY, IN 47150-4929
(812) 945-3223
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
01034016
IN
207YS0123X
Facial Plastic Surgery Physician
23772
KY
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
01034016
IN
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
23772
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323054
ANTHEM BCBS
—
05
—
100116140A
—
IN
01
—
1629134739
NPI DR. DONN R. CHATHAM
—
05
—
64237720
—
KY
01
—
DB7559
RAILROAD MEDICARE GROUP
IN
01
—
DC6172
RAILROAD MEDICARE GROUP
KY
01
—
P00125999
RAILROAD MEDICARE PIN
IN
01
—
P00180026
RAILROAD MEDICARE PIN
KY
Enumeration date
10/12/2006
Last updated
10/24/2011
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