Provider Demographics
NPI:1396065090
Name:DR JAY M CHAPMAN VISION CENTER
Entity type:Organization
Organization Name:DR JAY M CHAPMAN VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:931-762-1364
Mailing Address - Street 1:234 S LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3707
Mailing Address - Country:US
Mailing Address - Phone:931-762-1364
Mailing Address - Fax:931-762-1371
Practice Address - Street 1:530 HIGHWAY 64 E
Practice Address - Street 2:SUITE 5
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-3049
Practice Address - Country:US
Practice Address - Phone:931-722-5009
Practice Address - Fax:931-722-5612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN512152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty