Healthcare Provider Details

I. General information

NPI: 1073579447
Provider Name (Legal Business Name): KAREN MAUREEN CHANDLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

IV. Provider business mailing address

PO BOX 31235
TUCSON AZ
85751-1235
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-1205
  • Fax: 520-324-3650
Mailing address:
  • Phone: 520-324-4100
  • Fax: 520-324-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00795
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number37520
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: