Provider Demographics
NPI:1073593315
Name:CHANDLER, LEON H JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:H
Last Name:CHANDLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 202113
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99520-2113
Mailing Address - Country:US
Mailing Address - Phone:907-868-4062
Mailing Address - Fax:907-929-8744
Practice Address - Street 1:4100 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 216
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5222
Practice Address - Country:US
Practice Address - Phone:907-563-2873
Practice Address - Fax:907-563-5852
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK999208VP0000X, 208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK0103468OtherWA DEPT OF L&I
AKMD0999Medicaid
AKC97032Medicare UPIN
AKK00WGBBGAMedicare PIN