MEDICARE: ANTHONY B. CHAPPELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	049510	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	341954	OTHER	GA	WELLCARE
2	702624	OTHER	GA	BCBS
3	10062274	OTHER	GA	AMERIGROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013908086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY B. CHAPPELL M.D.

Provider Business Mailing Address
First Line	:	1076 BERMUDA RUN ROAD
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30458-0858
Country	:	US
Telephone Number	:	912-871-7810
Fax Number	:	912-871-7820

Provider Business Practice Location Address
First Line	:	1076 BERMUDA RUN ROAD
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30458-0858
Country	:	US
Telephone Number	:	912-871-7810
Fax Number	:	912-871-7820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	03/19/2012

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Directions to “ ANTHONY B. CHAPPELL M.D.” Practice Location

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