Healthcare Provider Details

I. General information

NPI: 1346325842
Provider Name (Legal Business Name): STANLEY L CHAPMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST ANESTHESIOLOGY - MOT
ATLANTA GA
30365
US

IV. Provider business mailing address

1410 WINSTON PL
DECATUR GA
30033-1951
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number000519
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: