Provider Demographics
NPI:1821056441
Name:CHAPMAN, KIMBERLY KAY DUNN (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY DUNN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1100 MALLARD PL STE D
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6850
Mailing Address - Country:US
Mailing Address - Phone:479-888-4787
Mailing Address - Fax:479-553-7475
Practice Address - Street 1:1100 MALLARD PL STE D
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6850
Practice Address - Country:US
Practice Address - Phone:479-888-4787
Practice Address - Fax:479-553-7475
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143817001Medicaid
5L930OtherMEDICARE UPIN
H41933Medicare UPIN