Provider Demographics
NPI:1508825803
Name:CHAPPLE, CRAIG JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:JOSEPH
Last Name:CHAPPLE
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 636643
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6643
Mailing Address - Country:US
Mailing Address - Phone:440-989-3801
Mailing Address - Fax:440-960-0264
Practice Address - Street 1:508 DICKSON ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:OH
Practice Address - Zip Code:44090-1300
Practice Address - Country:US
Practice Address - Phone:440-647-2225
Practice Address - Fax:440-647-5110
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3025372Medicaid
OH0236248Medicaid
OH0432811Medicaid
OHA79380Medicare UPIN
OH3025372Medicaid
OH0432811Medicaid
OH0476459Medicare PIN