Provider Demographics
NPI:1760595946
Name:CHANDLER, BRIAN R (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:R
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 CHURCHMANS ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3152
Mailing Address - Country:US
Mailing Address - Phone:302-322-3304
Mailing Address - Fax:302-322-3306
Practice Address - Street 1:819 CHURCHMANS ROAD EXT
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3152
Practice Address - Country:US
Practice Address - Phone:302-322-3304
Practice Address - Fax:302-322-3306
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0529674000OtherAMERIHEALTH
DE409623OtherCOVENTRY
DE510381373OtherCIGNA
DE2276361OtherFIRST HEALTH
DE510381373OtherBLUE CROSS
DE0529674000OtherKEYSTONE HEALTH PLAN EAST
DE2122380OtherMAMSI/OPTIMA CHOICE
DE510381373OtherUNITED HEALTH CARE
DE510381373OtherAETNA
DEAS68777770001OtherCIGNA
DE2219986OtherAETNA
DEAS68777770001OtherCIGNA
DE490291Medicare PIN