Healthcare Provider Details
I. General information
NPI: 1386752723
Provider Name (Legal Business Name): STEPHEN W CHANDLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/27/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 TAYLOR RD STE 2200
MONTGOMERY AL
36117-3571
US
IV. Provider business mailing address
301 BROWN SPRINGS RD
MONTGOMERY AL
36117-7005
US
V. Phone/Fax
- Phone: 334-747-7500
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 00024603 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: