Provider Demographics
NPI:1699199505
Name:CHAPMAN, LAWRENCE I (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:I
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:WY
Mailing Address - Zip Code:83014-1109
Mailing Address - Country:US
Mailing Address - Phone:307-734-5072
Mailing Address - Fax:
Practice Address - Street 1:3675 GOLDENEYE RD
Practice Address - Street 2:
Practice Address - City:WISON
Practice Address - State:WY
Practice Address - Zip Code:83014-1109
Practice Address - Country:US
Practice Address - Phone:307-734-5072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.039770207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology