Healthcare Provider Details

I. General information

NPI: 1437175429
Provider Name (Legal Business Name): PHILIP RANDALL CHAPMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH STREET SOUTH
BIRMINGHAM AL
35249-1900
US

IV. Provider business mailing address

500 22ND STREET SOUTH SUITE 510 FINANCE
BIRMINGHAM AL
35233-3110
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4011
  • Fax:
Mailing address:
  • Phone: 205-731-9662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number27552
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD00040738
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number27552
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: