Healthcare Provider Details

I. General information

NPI: 1730507666
Provider Name (Legal Business Name): CHELSEA KILPATRICK CHANDLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CHELSEA CHANDLER JONES

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 JESSE JEWELL PKWY NE STE 110
GAINESVILLE GA
30501-3816
US

IV. Provider business mailing address

PO BOX 742616
ATLANTA GA
30374-2616
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-9380
  • Fax:
Mailing address:
  • Phone: 770-219-8420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number89628
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: