Provider Demographics
NPI:1255338752
Name:JUMPER, CHADLER M (MD)
Entity type:Individual
Prefix:DR
First Name:CHADLER
Middle Name:M
Last Name:JUMPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:210 FORGE RD STE 2
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17007-9787
Practice Address - Country:US
Practice Address - Phone:717-254-6109
Practice Address - Fax:717-701-8522
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1M1041OtherMEDICARE
PA1010984510003Medicaid
3502038OtherAETNA HEALTH PLANS
P00137663OtherRAILROAD MEDICARE
H90662Medicare UPIN
PA1502975OtherHIGHMARK BLUE SHIELD
071921F9LMedicare ID - Type Unspecified
PA1010984510001Medicaid