Provider Demographics
NPI:1790146223
Name:JOHN CHAPMAN LLC
Entity Type:Organization
Organization Name:JOHN CHAPMAN LLC
Other - Org Name:TECHE DERMATOLOGIC SURGERY CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-385-5861
Mailing Address - Street 1:101 RUE FONTAINE BLDG 4
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5744
Mailing Address - Country:US
Mailing Address - Phone:337-385-5861
Mailing Address - Fax:337-385-5862
Practice Address - Street 1:101 RUE FONTAINE BLDG 4
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5744
Practice Address - Country:US
Practice Address - Phone:337-385-5861
Practice Address - Fax:337-385-5862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.32941207N00000X, 207ND0101X
LAMD.204848207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA488190Medicare PIN