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General NPI Number Information
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NPI Number | 1558326561
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Entity Type | Individual
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Provider Name | KEITH EDWIN CHAPMAN RPH
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 23 LEE ST
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City | JEFFERSON
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State | GA
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Zip | 30549-1345
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Country | US
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Telephone | 706-367-5221
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Fax | 706-367-4036
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Provider Business Mailing Address
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Address Line | 300 CRYSTAL CREEK DR
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City | HULL
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State | GA
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Zip | 30646-4302
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Country | US
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Telephone | 706-207-8086
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Fax | 706-367-4036
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18318
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License Number State | GA
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