Dr. Charles R. Sturtevant, O.D.

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

02168 Issued in TX

Legal business name

DR. CHARLES R. STURTEVANT, O.D.

Practice address

2100 S W S Young Dr Ste 1000a
Killeen, TX 76543-5320

Phone

(254) 953-1164

Fax

(254) 953-1192

NPI assigned

Mar 6, 2009

Last updated

Mar 6, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Roy Sturtevant Sr., O.D.

Title

Owner

Phone

(254) 953-1164

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1780825521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S W S YOUNG DR STE 1000A",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435320",
            "telephone_number": "254-953-1164",
            "fax_number": "254-953-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S W S YOUNG DR STE 1000A",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435320",
            "telephone_number": "254-953-1164",
            "fax_number": "254-953-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CHARLES R. STURTEVANT, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "STURTEVANT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-953-1164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TX",
            "license": "02168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Killeen, TX
• Providers in Killeen, TX by specialty
• Point of Service in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.