Individual
BRENT C CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 373-7850
Mailing address
283 E 930 S, OREM, UT 84058-5001
(801) 225-6246
(801) 225-1525
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
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