Provider Demographics
NPI:1104024470
Name:CHAPMAN, BUFFYE L (SLP)
Entity Type:Individual
Prefix:MS
First Name:BUFFYE
Middle Name:L
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 HILLANDALE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3249
Mailing Address - Country:US
Mailing Address - Phone:601-519-6328
Mailing Address - Fax:601-371-6993
Practice Address - Street 1:544 HILLANDALE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-3249
Practice Address - Country:US
Practice Address - Phone:601-519-6328
Practice Address - Fax:601-371-6993
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03537511Medicaid