Healthcare Provider Details

I. General information

NPI: 1346205010
Provider Name (Legal Business Name): DALE A CHAPMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 N MAPLE AVE
NEW HAMPTON IA
50659-1142
US

IV. Provider business mailing address

600 1ST ST NW STE 101
MASON CITY IA
50401-2932
US

V. Phone/Fax

Practice location:
  • Phone: 641-392-2151
  • Fax: 641-394-1999
Mailing address:
  • Phone: 641-394-2151
  • Fax: 641-394-1999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR8J39
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO-05542
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR8J39
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: