| Organization Name: | CHADRON MEDICAL CLINIC PC |
| NPI Number: | 1417167370 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERESA J LANDRETH (OFFICE MANAGER) |
| Mailing Address: | 825 Centennial Dr Chadron |
| State: | NE US |
| Postal Code: | 693379400 |
| Phone Number: | 3084324441 |
| Fax Number: | 3084324446 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 06/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |