Provider Demographics
NPI:1477142669
Name:CHAPMAN, SUSAN EXLEY (RPH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:EXLEY
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 OAK ST
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-6501
Mailing Address - Country:US
Mailing Address - Phone:706-485-5832
Mailing Address - Fax:706-484-2794
Practice Address - Street 1:809 OAK ST
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-6501
Practice Address - Country:US
Practice Address - Phone:706-485-5832
Practice Address - Fax:706-484-2794
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist