Provider Demographics
NPI:1548345093
Name:CHAPMAN, TERREL (DPH)
Entity type:Individual
Prefix:DR
First Name:TERREL
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3762 MASONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-4012
Mailing Address - Country:US
Mailing Address - Phone:901-345-1476
Mailing Address - Fax:901-345-4090
Practice Address - Street 1:1977 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-7713
Practice Address - Country:US
Practice Address - Phone:901-946-8852
Practice Address - Fax:901-942-6308
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC-4415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC-4415OtherLISCENSE NUMBER