MEDICARE: DR. TAMMY MAE CHAPMAN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY0005988	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54533	OTHER	FL	BLUE CROSS

General Provider Information

NPI Number	:	1235124801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMMY MAE CHAPMAN PH.D.

Provider Business Mailing Address
First Line	:	3404 WEEMS RD
Second Line	:	SUITE B-2
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-7506
Country	:	US
Telephone Number	:	850-523-4261
Fax Number	:	850-878-7205

Provider Business Practice Location Address
First Line	:	3404 WEEMS RD
Second Line	:	SUITE B-2
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-7506
Country	:	US
Telephone Number	:	850-523-4261
Fax Number	:	850-878-7205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/08/2007

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