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Individual

CRAIG W CHANDLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1532 W 32ND ST, STE 201, JOPLIN, MO 64804-1607
(417) 347-8660
(417) 347-8691
Mailing address
PO BOX 3810, JOPLIN, MO 64803
(417) 347-8660
(417) 347-8691

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
118846
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100181820A
OK
05
100181820B
OK
05
100373840A
KS
05
100373840B
KS
01
127808
ANTHEM
MO
01
160048923
RR MEDICARE
05
245000021
MO
Enumeration date
06/27/2006
Last updated
01/26/2009
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