Provider Demographics
NPI:1508860396
Name:CHAPMAN, JEFF L (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:L
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16205 W 64TH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7401
Mailing Address - Country:US
Mailing Address - Phone:303-424-2991
Mailing Address - Fax:303-467-2486
Practice Address - Street 1:16205 W 64TH AVE
Practice Address - Street 2:STE 100
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-7401
Practice Address - Country:US
Practice Address - Phone:303-424-2991
Practice Address - Fax:303-467-2486
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1507152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3892840001Medicare NSC
COU22432Medicare UPIN
COC528748Medicare PIN