Provider Demographics
NPI:1588667307
Name:CHAPEL, WILLIAM C JR (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:CHAPEL
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 THIRD ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-4013
Mailing Address - Country:US
Mailing Address - Phone:985-643-7247
Mailing Address - Fax:985-643-7864
Practice Address - Street 1:2769 3RD ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-4013
Practice Address - Country:US
Practice Address - Phone:985-643-7247
Practice Address - Fax:985-643-7864
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2011-01-06
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
LA317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1953415Medicaid
LAT20072Medicare UPIN
LA59400Medicare ID - Type Unspecified