Provider Demographics
NPI:1063431039
Name:CHAPMAN, TAMARA PURKISS (DPT)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:PURKISS
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:JOAN
Other - Last Name:PURKISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 682446
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-2446
Mailing Address - Country:US
Mailing Address - Phone:866-800-9147
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:6420 DUTCHMAN PARKWAY
Practice Address - Street 2:195
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205
Practice Address - Country:US
Practice Address - Phone:502-895-9188
Practice Address - Fax:502-895-9122
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0717701Medicare PIN
IN187330AMedicare PIN