Healthcare Provider Details

I. General information

NPI: 1124100706
Provider Name (Legal Business Name): ARTHUR CHANDLER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HURLEY AVE
KINGSTON NY
12401-2400
US

IV. Provider business mailing address

802 COLUMBIA ST SUITE 2
HUDSON NY
12534-2306
US

V. Phone/Fax

Practice location:
  • Phone: 845-339-2804
  • Fax: 845-338-5982
Mailing address:
  • Phone: 518-751-1016
  • Fax: 518-751-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number211077
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number211077
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: