Organization
JEFFREY L. CHANDLER, DPM
Active
Organization
JEFFREY L. CHANDLER, DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY L CHANDLER DPM (PODIATRIST)
(208) 344-3324
Entity
Organization
Contact information
Practice address
222 N 2ND ST STE 301, BOISE, ID 83702-6131
(208) 344-3324
(208) 344-4349
Mailing address
222 N 2ND ST STE 301, BOISE, ID 83702-6131
(208) 344-3324
(208) 344-4349
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P-73
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10015614
BLUE SHIELD OF IDAHO
—
05
—
1659354470
—
ID
01
—
480033367
RAILROAD MEDICARE
—
01
—
P0730
BLUE CROSS IDAHO
ID
Enumeration date
05/09/2011
Last updated
05/17/2011
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