Individual
BRENT C CHANDLER
Active
Individual
BRENT C CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
150277-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107006208103
IHC
UT
01
—
6176
DMBA
UT
01
—
870284448CH1
EMIA
UT
Enumeration date
05/17/2006
Last updated
10/26/2007
Update your record
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