Provider Demographics
NPI:1588670426
Name:CHAPMAN, RALPH KANE (DENTIST DMD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:KANE
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DENTIST DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 469
Mailing Address - Street 2:314 W SOUTH ST
Mailing Address - City:PINCKNEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62274
Mailing Address - Country:US
Mailing Address - Phone:618-357-2445
Mailing Address - Fax:618-357-9549
Practice Address - Street 1:BOX 469
Practice Address - Street 2:314 W SOUTH ST
Practice Address - City:PINCKNEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62274
Practice Address - Country:US
Practice Address - Phone:618-357-2445
Practice Address - Fax:618-357-9549
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist