Provider Demographics
NPI:1982776951
Name:EADY, T. (OD)
Entity Type:Individual
Prefix:DR
First Name:T.
Middle Name:
Last Name:EADY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 OLD GEORGE WASHINGTON HWY N STE R
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2209
Mailing Address - Country:US
Mailing Address - Phone:757-558-8439
Mailing Address - Fax:
Practice Address - Street 1:838 OLD GEORGE WASHINGTON HWY N STE R
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2209
Practice Address - Country:US
Practice Address - Phone:757-558-8439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000313152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist