Provider Demographics
NPI:1548693021
Name:LORD, BRITTANY CHANDLER (MD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:CHANDLER
Last Name:LORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 PLAZA AVE
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-6763
Mailing Address - Country:US
Mailing Address - Phone:478-374-3814
Mailing Address - Fax:478-374-1478
Practice Address - Street 1:1223 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6763
Practice Address - Country:US
Practice Address - Phone:478-374-3814
Practice Address - Fax:478-374-1478
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84899208000000X
GA009130208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics