Provider Demographics
NPI:1326202656
Name:CHAMBERLAND, SCOTT P (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:P
Last Name:CHAMBERLAND
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 1:831 ARONDALE CRES
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3107
Mailing Address - Country:US
Mailing Address - Phone:617-530-0141
Mailing Address - Fax:
Practice Address - Street 1:1100 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2336
Practice Address - Country:US
Practice Address - Phone:931-393-2020
Practice Address - Fax:931-455-6501
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001775152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist