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General NPI Number Information
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NPI Number | 1659463578
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Entity Type | Individual
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Provider Name | JAMES RUSSELL CHANDLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 FISHER ROAD CENTRAL VERMONT HOSPITAL
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City | BARRE
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State | VT
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Zip | 05401
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Country | US
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Telephone | 802-371-4315
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Fax | 802-371-5352
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Provider Business Mailing Address
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Address Line | 1350 CROSSTOWN RD
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City | BERLIN
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State | VT
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Zip | 05602-9025
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Country | US
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Telephone | 802-229-4411
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Fax | 802-371-4852
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0420005177
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License Number State | VT
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