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Individual

MR. CHAD CHANDLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8087
(334) 793-8191
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 793-8087
(334) 793-8191

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-074089
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051555520
AL
Enumeration date
04/18/2006
Last updated
05/11/2009
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