Organization
NORWOOD FAMILY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAKA CHANELLE NORWOOD OD (OPTOMETRIST/OWNER)
(817) 223-7294
Entity
Organization
Contact information
Practice address
2120 EMPORIUM DR, JACKSON, TN 38305
(731) 984-7000
(731) 984-7001
Mailing address
2120 EMPORIUM DR, JACKSON, TN 38305
(731) 984-7000
(731) 984-7001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3061
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08859508
—
MS
05
—
1528670
—
TN
Enumeration date
08/30/2012
Last updated
09/10/2012
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