Healthcare Provider Details

I. General information

NPI: 1295479194
Provider Name (Legal Business Name): CHANDLER SUZANNE DELAHUNT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 MDG/SGGM 4175 SOUTH ALAMO AVENUE
D-M AFB AZ
85707-4406
US

IV. Provider business mailing address

4175 S ALAMO AVE
DM AFB AZ
85707-4402
US

V. Phone/Fax

Practice location:
  • Phone: 520-228-2850
  • Fax:
Mailing address:
  • Phone: 520-228-2850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: