Basic Information
Provider Information
NPI: 1316135429
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: DARREN
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2120 LAKELAND HILLS BLVD
Address2:  
City: LAKELAND
State: FL
PostalCode: 338052906
CountryCode: US
TelephoneNumber: 8636882334
FaxNumber: 8635771167
Practice Location
Address1: 2120 LAKELAND HILLS BLVD
Address2:  
City: LAKELAND
State: FL
PostalCode: 338052906
CountryCode: US
TelephoneNumber: 8636882334
FaxNumber: 8635771167
Other Information
ProviderEnumerationDate: 10/15/2007
LastUpdateDate: 01/26/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XME106419FLY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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