Individual
KENNETH R CHAFFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1316 E. 7TH STREET, SUITE 3, AUBURN, IN 46706-2539
(260) 333-7704
(260) 333-7705
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01028114A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100152470
—
IN
05
—
3134012
—
OH
Enumeration date
10/31/2006
Last updated
09/16/2019
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