Provider Demographics
NPI:1073019691
Name:CHANDLER, JAMES M
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15921 SKY RUN DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8427
Mailing Address - Country:US
Mailing Address - Phone:405-779-5501
Mailing Address - Fax:
Practice Address - Street 1:15921 SKY RUN DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-8427
Practice Address - Country:US
Practice Address - Phone:405-779-5501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist