Basic Information
| Provider Information | |||||||||
| NPI: | 1437175429 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPMAN | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | RANDALL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 22ND STREET SOUTH | ||||||||
| Address2: | SUITE 510 FINANCE | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352333110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057319662 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 19TH STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352491900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059344011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 08/31/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | 27552 | AL | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | MD00040738 | WA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 00118740 | 05 | MS | MEDICAID | P00608183 | 01 | RAILROAD MEDICARE | OTHER | 009913899 | 05 | AL | MEDICAID | 009913900 | 05 | AL | MEDICAID | 101952 | 05 | AL | MEDICAID | 009913897 | 05 | AL | MEDICAID | 009913901 | 05 | AL | MEDICAID | 051546479 | 01 | AL | BCBS | OTHER | 051546481 | 01 | AL | BCBS | OTHER | 051546480 | 01 | AL | BCBS | OTHER | 051546482 | 01 | AL | BCBS | OTHER | 051549108 | 01 | AL | BCBS | OTHER |