Healthcare Provider Details

I. General information

NPI: 1518143122
Provider Name (Legal Business Name): DANA J CHANDLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S CROSS BRIDGES RD
MT PLEASANT TN
38474-1714
US

IV. Provider business mailing address

854 W JAMES CAMPBELL BLVD SUITE 303
COLUMBIA TN
38401-4659
US

V. Phone/Fax

Practice location:
  • Phone: 931-379-5821
  • Fax: 931-379-5867
Mailing address:
  • Phone: 931-490-7019
  • Fax: 931-379-5867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2041
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: