Provider Demographics
NPI:1285497966
Name:CHAPMAN, GREGORY JOSEPH
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:JOSEPH
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S 70TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-5292
Mailing Address - Country:US
Mailing Address - Phone:479-461-4846
Mailing Address - Fax:
Practice Address - Street 1:3400 S 70TH ST STE B
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5292
Practice Address - Country:US
Practice Address - Phone:479-461-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR686237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist