Provider Demographics
NPI:1235275215
Name:CHAMBERS, JOHN LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEE
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-0250
Mailing Address - Country:US
Mailing Address - Phone:423-272-7124
Mailing Address - Fax:423-272-8955
Practice Address - Street 1:120 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-3602
Practice Address - Country:US
Practice Address - Phone:423-272-7124
Practice Address - Fax:423-272-8955
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN53629OtherDAVIS VISION
TN0145064OtherBCBS OF TN
TN3599219Medicaid
TN0560690002Medicare NSC
T61202Medicare UPIN
TN3599219Medicaid