Provider Demographics
NPI:1760164495
Name:CHILTON, AIMEE BRADY (OD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:BRADY
Last Name:CHILTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:MARIE
Other - Last Name:BRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:417 WHITE ASH LOOP
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9570
Mailing Address - Country:US
Mailing Address - Phone:985-778-6394
Mailing Address - Fax:
Practice Address - Street 1:1431 OCHSNER BLVD STE A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8246
Practice Address - Country:US
Practice Address - Phone:985-875-7898
Practice Address - Fax:985-875-9844
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2006-953AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist