Provider Demographics
NPI:1205433414
Name:CHANDLER, DUSTIN JAMES (RPH)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:JAMES
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2520
Mailing Address - Country:US
Mailing Address - Phone:615-264-3583
Mailing Address - Fax:615-822-0163
Practice Address - Street 1:198 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2520
Practice Address - Country:US
Practice Address - Phone:615-264-3583
Practice Address - Fax:615-822-0163
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist