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General NPI Number Information
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NPI Number | 1982679296
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA VISION CENTER, PLC
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 2158 NORTHGATE PARK LN SUITE 302
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6957
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Country | US
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Telephone | 423-870-4900
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Fax | 423-870-5889
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Provider Business Mailing Address
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Address Line | 2158 NORTHGATE PARK LN SUITE 302
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6957
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Country | US
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Telephone | 423-870-4900
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Fax | 423-870-5889
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. THOMAS M REYNOLDS
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Credential | M.D.
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Telephone | 423-870-4900
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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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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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