Individual
DR. JERRY WAYNE CHANDLER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7608
Mailing address
476 SUMMERSET DR, SAINT JOHNS, FL 32259-8890
(757) 572-1899
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102201507
VA
207RC0000X
Cardiovascular Disease Physician
Primary
0102201507
VA
Other
Enumeration date
02/14/2006
Last updated
10/29/2014
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