| Chilson Clinic Pc | |
|
1 Kim Ave Ste 4 Tunkhannock PA 18657-9101 | |
| (570) 836-4400 | |
| (570) 836-4440 |
| Full Name | Chilson Clinic Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Kim Ave Ste 4, Tunkhannock, Pennsylvania |
| Authorized Official Name and Position | Terrance Scott Chilson (PRESIDENT) |
| Authorized Official Contact | 5708364400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chilson Clinic Pc 1 Kim Ave Ste 4 Tunkhannock PA 18657-9101 Ph: (570) 836-4400 | Chilson Clinic Pc 1 Kim Ave Ste 4 Tunkhannock PA 18657-9101 Ph: (570) 836-4400 |
| NPI Number | 1700852613 |
|---|---|
| Provider Enumeration Date | 02/28/2006 |
| Last Update Date | 09/21/2012 |
| Medicare PECOS PAC ID | 5092740217 |
|---|---|
| Medicare Enrollment ID | O20050927000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700852613 | NPI | - | NPPES |
| 1014661730001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD419105 (Pennsylvania) | Primary |
| Provider Name | Terrance Scott Chilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356317267 PECOS PAC ID: 1254366479 Enrollment ID: I20050927000983 |
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