=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073952081
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARK ROBINSON CHANDLER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2013
-----------------------------------------------------
Last Update Date | 08/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 N JUSTICE ST
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-696-1000
-----------------------------------------------------
Fax | 828-696-1314
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 N JUSTICE ST # 16
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28791-3410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-694-8350
-----------------------------------------------------
Fax | 828-694-7654
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | ME126228
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | TRN18880
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 2017-02300
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------