Provider Demographics
NPI:1346387677
Name:DAVID G. CHANDLER, OD
Entity Type:Organization
Organization Name:DAVID G. CHANDLER, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-238-1100
Mailing Address - Street 1:2427 AL HIGHWAY 202 STE C
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-5391
Mailing Address - Country:US
Mailing Address - Phone:256-238-1100
Mailing Address - Fax:256-231-7747
Practice Address - Street 1:2427 AL HIGHWAY 202 STE C
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-5391
Practice Address - Country:US
Practice Address - Phone:256-238-1100
Practice Address - Fax:256-231-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-523152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG032OtherMEDICARE GROUP UPIN
AL0253220004Medicare NSC
ALG032OtherMEDICARE GROUP UPIN
ALT69151Medicare UPIN