Basic Information
| Provider Information | |||||||||
| NPI: | 1194797068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPMAN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 15349 | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323175349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8505237410 | ||||||||
| FaxNumber: | 8505237490 | ||||||||
| Practice Location | |||||||||
| Address1: | 1491 GOVERNORS SQUARE BLVD | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323013049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8505237410 | ||||||||
| FaxNumber: | 8505237490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 06/30/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME39276 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 041504900 | 05 | FL | MEDICAID |