Basic Information
| Provider Information | |||||||||
| NPI: | 1548412737 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHARLES P GILCHRIST OD INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHARLES P GILCHRIST OD INC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 402 AIRPORT RD | ||||||||
| Address2: | P.O. BOX 1137 | ||||||||
| City: | TAPPAHANNOCK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225605431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8044435388 | ||||||||
| FaxNumber: | 8044435389 | ||||||||
| Practice Location | |||||||||
| Address1: | 402 AIRPORT RD | ||||||||
| Address2: | |||||||||
| City: | TAPPAHANNOCK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8044435388 | ||||||||
| FaxNumber: | 8044435389 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2008 | ||||||||
| LastUpdateDate: | 07/02/2014 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GILCHRIST | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8044435388 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | OD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | 0618000691 | VA | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.