Provider Demographics
NPI:1902866064
Name:CHAPPELL, JAMES ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:CHAPPELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 719
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-0719
Mailing Address - Country:US
Mailing Address - Phone:276-601-2074
Mailing Address - Fax:276-601-2079
Practice Address - Street 1:211 NORTH JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2846
Practice Address - Country:US
Practice Address - Phone:276-601-2074
Practice Address - Fax:276-601-2079
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102037222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005605202Medicaid
VA460781OtherANTHEM
VAF90911Medicare UPIN
VA460781OtherANTHEM
000014F69Medicare PIN