Individual
CONNIE A CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
145 KATHERINE AVE, OZARK, AL 36360-1976
(334) 774-5116
Mailing address
PO BOX 863, OZARK, AL 36361-0863
(334) 443-1211
(334) 443-0131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4122
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185389
—
AL
01
—
511-78140
BLUE CROSS AND BLUE SHIELD
AL
Enumeration date
06/08/2006
Last updated
01/30/2018
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