Provider Demographics
NPI:1366620023
Name:ANDREW J. CHAPMAN
Entity type:Organization
Organization Name:ANDREW J. CHAPMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:276-523-3696
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-0328
Mailing Address - Country:US
Mailing Address - Phone:276-523-3696
Mailing Address - Fax:276-523-4806
Practice Address - Street 1:2537 4TH AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3601
Practice Address - Country:US
Practice Address - Phone:276-523-3696
Practice Address - Fax:276-523-4806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000781332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1391888OtherUMWA
VA9300121Medicaid
VA244155OtherANTHEM BLUE CROSS
VA9300121Medicaid
VA480000230Medicare PIN
VA0867550001Medicare NSC