Healthcare Provider Details

I. General information

NPI: 1326472291
Provider Name (Legal Business Name): JOEL P. CAUSEY OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 191 AND HOSPITAL ROAD
CHINLE AZ
86503
US

IV. Provider business mailing address

PO BOX PH
CHINLE AZ
86503-8000
US

V. Phone/Fax

Practice location:
  • Phone: 928-674-7166
  • Fax: 928-674-7705
Mailing address:
  • Phone: 928-674-7166
  • Fax: 928-674-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618002253
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-2024-0002
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: