MEDICARE: DR. CHASE HARTER 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	2773	AR
2	152W00000X	Optometrist	OPT.006934	OH

General Provider Information

NPI Number	:	1861986358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHASE HARTER OD

Provider Business Mailing Address
First Line	:	4140 HOOVER RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-3625
Country	:	US
Telephone Number	:	614-801-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 HOOVER RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-3625
Country	:	US
Telephone Number	:	614-801-2020
Fax Number	:

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

Provider Enumeration Date	:	06/18/2018
Last Update Date	:	08/31/2022

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Directions to “ DR. CHASE HARTER OD” Practice Location

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