Healthcare Provider Details

I. General information

NPI: 1568183994
Provider Name (Legal Business Name): CHANDLER MORGAN SAMUEL STEELE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N WILMOT RD
TUCSON AZ
85711-2602
US

IV. Provider business mailing address

PO BOX 20802
BELFAST ME
04915-4105
US

V. Phone/Fax

Practice location:
  • Phone: 520-296-3211
  • Fax:
Mailing address:
  • Phone: 520-296-3211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number104338
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number78967
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: