Provider Demographics
NPI:1205408820
Name:CURTIS, CHANDLER B (PA)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:B
Last Name:CURTIS
Suffix:
Gender:F
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:1901 E 32ND ST STE 4
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3071
Mailing Address - Country:US
Mailing Address - Phone:417-781-0250
Mailing Address - Fax:417-781-2581
Practice Address - Street 1:1901 E 32ND ST STE 4
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3071
Practice Address - Country:US
Practice Address - Phone:417-781-0250
Practice Address - Fax:417-781-2581
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2021021450363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant