Provider Demographics
NPI:1831385897
Name:CHAPPELL, JOHNATHAN LANGSTON (MD)
Entity type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:LANGSTON
Last Name:CHAPPELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4450 CALIBRE XING NW
Mailing Address - Street 2:SUITE 1208
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-4103
Mailing Address - Country:US
Mailing Address - Phone:678-505-8030
Mailing Address - Fax:678-505-8263
Practice Address - Street 1:4450 CALIBRE XING NW
Practice Address - Street 2:SUITE 1208
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4103
Practice Address - Country:US
Practice Address - Phone:678-505-8030
Practice Address - Fax:678-505-8263
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2015-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA056975207N00000X, 207ND0101X, 207ZD0900X, 207NP0225X, 207NS0135X, 208D00000X, 207ND0900X
DCMD036880207N00000X
GA56975207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I070591Medicare PIN