Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 32941 | AL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | MD.204848 | LA |
N | 207P00000X | Emergency Physician | 204848 | LA |
NPI | 1437474772 |
---|---|
Provider Name | Dr. John Charles Chapman |
First Address | Lafayette, LA 70508-5744 |
Second Address | Lafayette, LA 70508-5744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 26/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2108026 | (05) | LA |
248577ZUKU | MEDICARE ID (01) | LA |