Healthcare Provider Details

I. General information

NPI: 1285734228
Provider Name (Legal Business Name): PAUL T CHANDLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9393 FIELDS ERTEL RD SUITE A
CINCINNATI OH
45249-8211
US

IV. Provider business mailing address

9393 FIELDS ERTEL RD SUITE A
CINCINNATI OH
45249-8211
US

V. Phone/Fax

Practice location:
  • Phone: 513-677-1919
  • Fax: 513-677-9379
Mailing address:
  • Phone: 513-677-1919
  • Fax: 513-677-9379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35039316
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35039316
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: