Provider Demographics
NPI:1073124871
Name:CHAPPIUS, RUSSELL WAYNE III (OD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:WAYNE
Last Name:CHAPPIUS
Suffix:III
Gender:M
Credentials:OD
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Mailing Address - Street 1:205 LAUREL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-3635
Mailing Address - Country:US
Mailing Address - Phone:856-455-5500
Mailing Address - Fax:856-455-5480
Practice Address - Street 1:205 LAUREL HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-3635
Practice Address - Country:US
Practice Address - Phone:856-455-5500
Practice Address - Fax:856-455-5480
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJNJ27OA00697900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist