Provider Demographics
NPI:1689645608
Name:CHAPMAN, PATRICIA ANNE (DPM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 5TH AVE S
Mailing Address - Street 2:PO BOX 218
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4309
Mailing Address - Country:US
Mailing Address - Phone:563-219-8903
Mailing Address - Fax:563-219-8905
Practice Address - Street 1:216 5TH AVE S
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4309
Practice Address - Country:US
Practice Address - Phone:563-219-8903
Practice Address - Fax:563-219-8905
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00695213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4186825Medicaid
IA1186825Medicaid
IA480029310OtherRAILROAD MEDICARE
IA12424OtherWELLMARK
IA4346690001Medicare NSC
IA12424OtherWELLMARK
IA1186825Medicaid