Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME79761 | FL |
NPI | 1023078102 |
---|---|
Provider Name | Dr. Karen Austin Chapman |
First Address | Fort Walton Beach, FL 32548-5066 |
Second Address | Fort Walton Beach, FL 32548-5066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 06/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
258293700 | (05) | FL |
H13852 | (02) | FL |