Provider Demographics
NPI:1306014170
Name:CHRISTOPHER OPTICAL
Entity Type:Organization
Organization Name:CHRISTOPHER OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:MCWHORTER
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:615-791-0953
Mailing Address - Street 1:100 COVEY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5063
Mailing Address - Country:US
Mailing Address - Phone:615-791-0953
Mailing Address - Fax:615-791-0121
Practice Address - Street 1:100 COVEY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5063
Practice Address - Country:US
Practice Address - Phone:615-791-0953
Practice Address - Fax:615-791-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPO0000000837156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1B0098164OtherBLUE CROSS BLUE SHIELD
TN6154358180OtherVSP
TN36394OtherDAVIS
TNTN0837OtherEYE MED
TN6154358180OtherVSP