Organization
CHADRON VISION CENTER, INC.
Active
Other names
Chadron Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L. CHANCELLOR O.D. (OWNER / OPTOMETRIST)
(308) 432-3222
Entity
Organization
Contact information
Practice address
241 E 3RD ST, CHADRON, NE 69337-2301
(308) 432-3222
(308) 432-5344
Mailing address
241 E 3RD ST, CHADRON, NE 69337-2301
(308) 432-3222
(308) 432-5344
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06763
BLUE CROSS BLUE SHIELD
NE
01
—
06923
BLUE CROSS BLUE SHIELD
NE
01
—
09902
BLUE CROSS BLUE SHIELD
NE
01
—
410017859
RR MEDICARE
—
01
—
410046153
RR MEDICARE
—
01
—
410046882
RR MEDICARE
—
05
—
9200332
—
SD
05
—
9200910
—
SD
05
—
9202140
—
SD
05
—
9203680
—
SD
01
—
P00390774
RR MEDICARE
—
Enumeration date
09/27/2005
Last updated
07/06/2011
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