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General NPI Number Information
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NPI Number | 1669596839
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Entity Type | Organization
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Legal Business Name | DOUGLAS O. CHARTERS & KENNETH L. HIEB
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 3749 S MOONEY BLVD
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City | VISALIA
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State | CA
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Zip | 93277-8000
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Country | US
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Telephone | 559-733-9966
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Fax | 559-625-8913
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Provider Business Mailing Address
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Address Line | 3749 S MOONEY BLVD
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City | VISALIA
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State | CA
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Zip | 93277-8000
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Country | US
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Telephone | 559-733-9966
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Fax | 559-625-8913
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Authorized Official
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Title or Position | PARTNER
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Name | DR. KENNETH LYLE HIEB
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Credential | O.D.
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Telephone | 559-733-9966
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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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