Kea, Joe Chaddrick
Kea, Joe Chaddrick is an sole proprietor health care provider with primary practice located at 3437 Tupelo Commons Suite 101, Tupelo MS 38804-9791. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kea, Joe Chaddrick can be contacted via phone (662) 842-2000.Contact Information
Primary practice address
3437 Tupelo Commons Suite 101
Tupelo MS 38804-9791
Phone: (662) 842-2000
Fax: (662) 842-0379
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 578 | Mississippi |
Profile Details
NPI number | 1053404012 |
---|---|
LBN Legal business name | Kea, Joe Chaddrick |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 2nd, 2006 |
Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053404012 | NPPES |
Mississippi | MEDICAID | 00880031 |
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