Provider Demographics
NPI:1417755042
Name:CHAPPELL, GRANT THOMAS
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:THOMAS
Last Name:CHAPPELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STETSON ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2353
Mailing Address - Country:US
Mailing Address - Phone:734-770-1844
Mailing Address - Fax:
Practice Address - Street 1:215 STETSON ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2353
Practice Address - Country:US
Practice Address - Phone:734-770-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program