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1912933151
CHANDOS DEWAYNE TACKETT
HUNTINGTON, WV
NPI
1912933151
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WV 18209)
Enumeration Date
2006-06-22
Last Update Date
2021-05-07
Business Address
CHANDOS DEWAYNE TACKETT MD
5170 US RT 60 EAST
HUNTINGTON, WV 25705
Phone number: 304-528-4663
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Mailing Address
CHANDOS DEWAYNE TACKETT MD
5170 US RT 60 EAST
HUNTINGTON, WV 25705
Phone number: 304-528-4663
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