Provider Demographics
NPI:1144214933
Name:CHANDLER, HOWARD C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:C
Last Name:CHANDLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 645
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1476
Mailing Address - Country:US
Mailing Address - Phone:404-605-2050
Mailing Address - Fax:404-355-8421
Practice Address - Street 1:2001 PEACHTREE RD NE
Practice Address - Street 2:SUITE 645
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1476
Practice Address - Country:US
Practice Address - Phone:404-605-2050
Practice Address - Fax:404-355-8421
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA068382207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I143128Medicare PIN
GA01710959OtherAMERIGROUP
MTE62755Medicare UPIN
FL277458500Medicaid
GA727144OtherMEDICAID WELLCARE
GA248713368BMedicaid
FLAB325ZMedicare PIN