Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 4767 | KY |
NPI | 1114054525 |
---|---|
Provider Name | Dr. James Andrew Chandler |
First Address | Lexington, KY 40503-1432 |
Second Address | Lexington, KY 40503-1432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60047677 | (05) | KY |