Sudarsan Chavala

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

R8855 Issued in MO

Legal business name

SUDARSAN CHAVALA

Doing business as

maryville eye clinic

Practice address

2024 S Main St
Maryville, MO 64468-2655

Phone

(660) 562-2566

Fax

(660) 562-2432

NPI assigned

Apr 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sudarsan Chavala, M.D.

Title

Ophthalmologist

Phone

(660) 562-2566

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• maryville eye clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1639292527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-2566",
            "fax_number": "660-562-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-2566",
            "fax_number": "660-562-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDARSAN CHAVALA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "CHAVALA",
        "authorized_official_first_name": "SUDARSAN",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "660-562-2566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R8855",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MO",
            "license": "R8855",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "180023483",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321965204",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201965209",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC",
            "identifier": "22841019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "maryville eye clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Steele, M.D.
• Douglas Henry Steiner, DC
• Keri Ann Stephenson, RD, LD, CDE
• Jessica Stiens
• Trenton Stumpff, R.PH.
• John T Symonds, DO
• Christina Tapps, MS, ATC, LAT
• Mark James Taylor
• Anna Michele Teale, OTR/L
• The Wellness Tripp

• Ophthalmology Physician in Maryville, MO
• Providers in Maryville, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.