Provider Demographics
NPI:1083386320
Name:CHANDLER MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:CHANDLER MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:850-261-9267
Mailing Address - Street 1:PO BOX 6504
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-6504
Mailing Address - Country:US
Mailing Address - Phone:406-324-7003
Mailing Address - Fax:406-442-6322
Practice Address - Street 1:2910 PROSPECT AVE STE 2
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-9726
Practice Address - Country:US
Practice Address - Phone:406-324-7003
Practice Address - Fax:406-442-6322
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHANDLER MEDICAL SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty