Provider Demographics
NPI:1265677132
Name:CHAPA-RODRIGUEZ, ALEJANDRO MA (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:MA
Last Name:CHAPA-RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11720
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86304
Mailing Address - Country:US
Mailing Address - Phone:928-771-5487
Mailing Address - Fax:928-771-5471
Practice Address - Street 1:1003 WILLOW CREEK ROAD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86304
Practice Address - Country:US
Practice Address - Phone:928-771-5487
Practice Address - Fax:928-771-5471
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43860207R00000X, 208M00000X
NC2019-02316208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z142366Medicare UPIN