Individual
CHANDRA KATHRYN FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2901 W JACKSON ST, MUNCIE, IN 47304-4307
(765) 747-4332
(765) 448-7689
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01083908A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102424289
ANTHEM PTAN
IN
05
—
201295010
—
IN
Enumeration date
06/07/2015
Last updated
10/18/2024
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