Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2015017224 | MO |
Y | 208600000X | Surgeon | 2015017224 | MO |
NPI | 1003297177 |
---|---|
Provider Name | William Chapman JR. |
First Address | St. Louis, MO 63110 |
Second Address | St. Louis, MO 63110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2015 |
Last Update Date | 15/06/2015 |