Healthcare Provider Details

I. General information

NPI: 1447368196
Provider Name (Legal Business Name): STEPHEN JAMES CHAPMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 WALNUT COMMONS LANE SUITE A
COOKEVILLE TN
38501-6037
US

IV. Provider business mailing address

120 WALNUT COMMONS LANE SUITE A
COOKEVILLE TN
38501-6037
US

V. Phone/Fax

Practice location:
  • Phone: 931-528-1331
  • Fax: 931-528-6893
Mailing address:
  • Phone: 931-528-1331
  • Fax: 931-528-6893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDPM0000000352
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM0000000352
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberDPM0000000352
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: