SUDARSAN CHAVALA NPI 1639292527

NPI Information

  • NPI: 1639292527
  • Provider Name: SUDARSAN CHAVALA
  • Classification: Ophthalmology - 207W00000X
  • Entity Type: Organization
  • Doing Business As: MARYVILLE EYE CLINIC
  • Address: 2024 S MAIN ST
    MARYVILLE, MO
    ZIP 64468
  • Phone: (660) 562-2566

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NPI Details

SUDARSAN CHAVALA is an ophthalmology in Maryville, MO. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. SUDARSAN CHAVALA NPI is 1639292527. The provider is registered as an organization entity type.
The provider Is Doing Business As Maryville Eye Clinic.

The provider's business location address is:

2024 S MAIN ST
MARYVILLE, MO
ZIP 64468-655
Phone: (660) 562-2566
Fax: (660) 562-2432

The provider's authorized official is Sudarsan Chavala .
The authorized official title is Ophthalmologist and has the following contact phone number (660) 562-2566.

The enumeration date for this NPI number is 4/7/2007 and was last updated on 6/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierR8855MISSOURINo
2207W00000XOphthalmologyR8855MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11315240001MEDICARE ID-TYPE UNSPECIFIEDMISSOURIOPTICAL STORE
222841019OTHERMISSOURIBCBS OF KC
30100000AMEDICARE ID-TYPE UNSPECIFIEDMISSOURIGROUP
4201965209MEDICAIDMISSOURI
5321965204MEDICAIDMISSOURI
6180023483OTHERMISSOURIMEDICARE RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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