=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902696180
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN E CHANDLER PA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2025
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2324 LIMESTONE OVERLOOK
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30501-7443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-536-8109
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2324 LIMESTONE OVERLOOK
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30501-7443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-536-8109
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 13191
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------