Provider Demographics
NPI:1740663400
Name:CHO, EDWARD (OD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:CHO
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 1:4198 SUMMER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-4004
Mailing Address - Country:US
Mailing Address - Phone:901-327-5884
Mailing Address - Fax:901-327-4347
Practice Address - Street 1:4198 SUMMER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-4004
Practice Address - Country:US
Practice Address - Phone:901-327-5884
Practice Address - Fax:901-327-4347
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD992152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist