Individual
JOHN MAC CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 S PINE ST, VIVIAN, LA 71082
(318) 375-3235
(318) 375-5938
Mailing address
815 S PINE ST, VIVIAN, LA 71082
(318) 375-3235
(318) 375-5938
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.019412
LA
207Q00000X
Family Medicine Physician
019412
LA
207Q00000X
Family Medicine Physician
MD.019412
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1900028
—
LA
01
—
MD.019412
LICENSE
LA
Enumeration date
06/29/2006
Last updated
12/30/2024
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