MEDICARE: JOE F CHANEY JR. OD

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	2259	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861485427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE F CHANEY JR. OD

Provider Business Mailing Address
First Line	:	119 W COLLEGE ST
Second Line	:
City	:	NASHVILLE
State	:	AR
Zip	:	71852-2017
Country	:	US
Telephone Number	:	870-845-2020
Fax Number	:	870-845-2020

Provider Business Practice Location Address
First Line	:	119 W COLLEGE ST
Second Line	:
City	:	NASHVILLE
State	:	AR
Zip	:	71852-2017
Country	:	US
Telephone Number	:	870-845-2020
Fax Number	:	870-845-2020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	08/27/2008

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