Provider Demographics
NPI:1396743357
Name:CHAPMAN, KENT DOUGLAS (DO)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:DOUGLAS
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TN
Mailing Address - Zip Code:37874-1181
Mailing Address - Country:US
Mailing Address - Phone:865-213-8200
Mailing Address - Fax:865-213-8596
Practice Address - Street 1:304 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874-1181
Practice Address - Country:US
Practice Address - Phone:865-213-8200
Practice Address - Fax:865-213-8596
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1257207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3305327Medicaid
4119634OtherBLUE CROSS
G35021Medicare UPIN
TN3305327Medicaid