Healthcare Provider Details

I. General information

NPI: 1174524060
Provider Name (Legal Business Name): VICKI L CHAPMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 29TH ST S STE 101
GREAT FALLS MT
59405-5316
US

IV. Provider business mailing address

1400 29TH ST S STE 101
GREAT FALLS MT
59405-5316
US

V. Phone/Fax

Practice location:
  • Phone: 406-761-7924
  • Fax:
Mailing address:
  • Phone: 406-761-7924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number7638
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number7638
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: