Individual
DR. CHANDLER H PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., MSC
Contact information
Practice address
1263 HOSPITAL DR NW STE 110, CORYDON, IN 47112-2173
(812) 734-0912
(502) 629-2055
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
48923
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201083260
—
IN
01
—
57.013780
CREDENTIAL NUMBER
OH
01
—
P01150420
RAILROAD MEDICARE
IN
Enumeration date
11/08/2007
Last updated
11/18/2024
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