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General NPI Number Information
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NPI Number | 1326210451
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Entity Type | Organization
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Legal Business Name | CALVERT OPTHALMOLOGY PSC
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 290 CLEAR SKY COURT
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City | CLARKSVILLE
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State | TN
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Zip | 37043
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Country | US
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Telephone | 931-647-4900
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Fax | 931-647-1333
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Provider Business Mailing Address
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Address Line | 100 KEETON DRIVE
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-8756
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Country | US
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Telephone | 270-886-2050
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Fax | 270-886-2007
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Authorized Official
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Title or Position | PRESIDENT/MD
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Name | HAROLD MILTON CALVERT
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Credential |
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Telephone | 270-886-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD0000035976
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License Number State | TN
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