Healthcare Provider Details

I. General information

NPI: 1114677382
Provider Name (Legal Business Name): CHANDLER MAGUET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 HARRODSBURG RD STE 125
LEXINGTON KY
40504-3543
US

IV. Provider business mailing address

2195 HARRODSBURG RD STE 125
LEXINGTON KY
40504-3504
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6371
  • Fax: 859-257-3585
Mailing address:
  • Phone: 859-257-4732
  • Fax: 859-323-6661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number60749
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: