Provider Demographics
NPI:1346205010
Name:CHAPMAN, DALE A (DO)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:A
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 1ST ST NW STE 101
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2932
Mailing Address - Country:US
Mailing Address - Phone:641-394-2151
Mailing Address - Fax:641-394-1999
Practice Address - Street 1:308 N MAPLE AVE
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50659-1142
Practice Address - Country:US
Practice Address - Phone:641-392-2151
Practice Address - Fax:641-394-1999
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8J39207Q00000X, 207R00000X
IADO-05542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO00719016OtherBLUE CROSS BLUE SHIELD OF KC
MO0100912OtherUNITED HEALTHCARE PIN
MO010047292OtherPALMETTO GBA
MO4649395OtherAETNA PIN
MO212202OtherHEALTHLINK PIN
MO242664621Medicaid
MOE69550OtherMERCY HEALTH PLANS PIN
MO4649395OtherAETNA PIN
MOMA2850Medicare PIN
KSE69550Medicare UPIN