Provider Demographics
NPI:1285626523
Name:CHAPMAN, DEANNA JOY (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:JOY
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 CENTERVILLE BUSINESS PKWY STE 117
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2690
Mailing Address - Country:US
Mailing Address - Phone:937-296-9806
Mailing Address - Fax:937-296-9805
Practice Address - Street 1:6601 CENTERVILLE BUSINESS PKWY STE 117
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-2690
Practice Address - Country:US
Practice Address - Phone:937-296-9806
Practice Address - Fax:937-296-9805
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002844213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2655327Medicaid
OHCH0759343Medicare PIN
U23878Medicare UPIN