Provider Demographics
NPI:1467567008
Name:CHAPMAN, REES CECIL III (PHD)
Entity Type:Individual
Prefix:DR
First Name:REES
Middle Name:CECIL
Last Name:CHAPMAN
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 GROVE ST N
Mailing Address - Street 2:STE D
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533
Mailing Address - Country:US
Mailing Address - Phone:706-864-0695
Mailing Address - Fax:844-733-7743
Practice Address - Street 1:385 GROVE ST N
Practice Address - Street 2:STE D
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533
Practice Address - Country:US
Practice Address - Phone:706-864-0695
Practice Address - Fax:844-733-7743
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005422103TC0700X
GA1740103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000615183AMedicaid
GA68BBCZGMedicare PIN