Individual
JAMES D. CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 BAUM STREET, AVILLA, IN 46710-0170
(260) 897-3556
(260) 897-3650
Mailing address
1234 E. DUPONT RD., SUITE 3, AVILLA, IN 46825-1545
(260) 897-3556
(260) 458-5664
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01022980
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000559371
ANTHEM
IN
01
—
000000570562
ANTHEM
IN
05
—
100190780A
—
IN
01
—
P00664344
MEDICARE RAILROAD
IN
Enumeration date
09/14/2005
Last updated
09/30/2009
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