Provider Demographics
NPI:1538157128
Name:CHAPMAN, ALVIN D (DMD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:D
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-0058
Mailing Address - Country:US
Mailing Address - Phone:478-987-7863
Mailing Address - Fax:478-987-7756
Practice Address - Street 1:233 WES PARK DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-4829
Practice Address - Country:US
Practice Address - Phone:478-987-7863
Practice Address - Fax:478-987-7756
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-08
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0096241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00415379AMedicaid