Provider Demographics
NPI:1982882528
Name:CHARLES A. SCHAIBLE, O.D.
Entity Type:Organization
Organization Name:CHARLES A. SCHAIBLE, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHAIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-272-4583
Mailing Address - Street 1:3601 SW 29TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2078
Mailing Address - Country:US
Mailing Address - Phone:785-272-4583
Mailing Address - Fax:
Practice Address - Street 1:3601 SW 29TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2078
Practice Address - Country:US
Practice Address - Phone:785-272-4583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS10603332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0188170001Medicare NSC