Provider Demographics
NPI:1659372092
Name:TRUMAN, CHAD A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:A
Last Name:TRUMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GOVERNORS DR SW FL 1
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5171
Mailing Address - Country:US
Mailing Address - Phone:256-801-6049
Mailing Address - Fax:256-539-0856
Practice Address - Street 1:201 GOVERNORS DR SW FL 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5171
Practice Address - Country:US
Practice Address - Phone:256-533-1600
Practice Address - Fax:256-539-0856
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105021363A00000X, 363AS0400X
ALPA.352363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002349600Medicaid
FLP01024462OtherMEDICARE RAILROAD PROVIDER NUMBER
FL002349600Medicaid
FLCB502XMedicare PIN
FLCB502YMedicare PIN
FLP01024462OtherMEDICARE RAILROAD PROVIDER NUMBER
FLCB502WMedicare PIN