Orr, Charles Russell

Orr, Charles Russell is an individual health care provider with primary practice located at 1492 Madison St , Clarksville TN 37040-3860. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Orr, Charles Russell can be contacted via phone (931) 648-0544.

Contact Information

Primary practice address
1492 Madison St Clarksville TN 37040-3860
Phone: (931) 648-0544
Fax: (931) 648-3625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODT580 Tennessee

Profile Details

NPI number 1962485359
LBN Legal business name Orr, Charles Russell
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Dec 29th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962485359 NPPES
Tennessee MEDICAID 3599631

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