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General NPI Number Information
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NPI Number | 1316228935
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Entity Type | Organization
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Legal Business Name | I-CHART LLC
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 176 SHELBY SPEIGHTS DR STE 7A
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City | PURVIS
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State | MS
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Zip | 39475-4554
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Country | US
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Telephone | 601-794-6600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 303
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City | PURVIS
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State | MS
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Zip | 39475-0303
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Country | US
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Telephone | 601-794-6600
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. HILARI D MCFARLAND
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Credential | O.D.
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Telephone | 601-794-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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