MEDICARE: DR TODD E CHONTOS & ASSOC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3931	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OH3931	OTHER	OH	EYEMED

General Provider Information

NPI Number	:	1225108756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR TODD E CHONTOS & ASSOC INC

Provider Business Mailing Address
First Line	:	2725 S HAMILTON RD # G5
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4904
Country	:	US
Telephone Number	:	614-863-0195
Fax Number	:	614-863-2701

Provider Business Practice Location Address
First Line	:	2725 S HAMILTON RD # G5
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4904
Country	:	US
Telephone Number	:	614-863-0195
Fax Number	:	614-863-2701

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TODD E. CHONTOS
Credential	:	O.D.
Telephone Number	:	614-863-0195

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/10/2008

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