Healthcare Provider Details

I. General information

NPI: 1215863311
Provider Name (Legal Business Name): CHANDLER CARLILE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 N BRAUER AVE APT 1B
OKLAHOMA CITY OK
73106-4262
US

IV. Provider business mailing address

1812 N BRAUER AVE APT 1B
OKLAHOMA CITY OK
73106-4262
US

V. Phone/Fax

Practice location:
  • Phone: 405-738-3557
  • Fax:
Mailing address:
  • Phone: 405-738-3557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: