Individual
LYDIA CHANTILAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-1793
(513) 672-3309
(513) 672-3323
Mailing address
11490 SPRINGFIELD PIKE, CINCINNATI, OH 45246-3524
(513) 672-3309
(513) 672-3323
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
32380
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64323801
—
KY
Enumeration date
08/24/2005
Last updated
01/30/2014
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