Provider Demographics
NPI:1982648390
Name:CHAPMAN, GLENN S III (DO)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:S
Last Name:CHAPMAN
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4600 N OCEAN BLVD
Mailing Address - Street 2:#101
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7365
Mailing Address - Country:US
Mailing Address - Phone:561-330-4300
Mailing Address - Fax:561-330-4514
Practice Address - Street 1:4600 N OCEAN BLVD
Practice Address - Street 2:#101
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7365
Practice Address - Country:US
Practice Address - Phone:561-330-4300
Practice Address - Fax:561-330-4514
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 9761204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00393644OtherMEDICARE RAILROAD
FLU7663ZMedicare PIN
FLI55365Medicare UPIN