Healthcare Provider Details

I. General information

NPI: 1043348659
Provider Name (Legal Business Name): CHAMBERLAIN MCDONALD FAMILY EYE CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15205 S BLACKBOB RD
OLATHE KS
66062-3316
US

IV. Provider business mailing address

15205 S BLACKBOB RD
OLATHE KS
66062-3316
US

V. Phone/Fax

Practice location:
  • Phone: 913-390-4900
  • Fax: 913-390-4970
Mailing address:
  • Phone: 913-390-4900
  • Fax: 913-390-4970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOANNA CLAIRE CHAMBERLAIN
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 913-390-4900