Provider Demographics
NPI:1144224122
Name:CHANDLER, DAVID RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAY
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17567
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32522-7567
Mailing Address - Country:US
Mailing Address - Phone:850-916-8490
Mailing Address - Fax:
Practice Address - Street 1:1040 GULF BREEZE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-7809
Practice Address - Country:US
Practice Address - Phone:850-916-3700
Practice Address - Fax:850-916-3710
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78171207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL592-32206OtherBCBS
FL47077OtherBLUE CROSS BLUE SHIELD
AL592-09144OtherBLUE CROSS BLUE SHIELD OF ALABAMA
FL019300500Medicaid
AL590-53038OtherBLUE CROSS BLUE SHIELD OF ALABAMA
FLA524OtherHEALTH FIRST NETWORK
FL2569167-00Medicaid
AL59232234OtherBCBS
FL470777VMedicare PIN
FL47077OtherBLUE CROSS BLUE SHIELD