| Organization Name: | NASHVILLE TN OPHTHALMOLOGY ASC LLC |
| NPI Number: | 1063452423 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP CLENDENIN (PRESIDENT) |
| Mailing Address: | 907 Rivergate Pkwy Suite C 2020 Goodlettsville |
| State: | TN US |
| Postal Code: | 370722324 |
| Phone Number: | 6158593121 |
| Fax Number: | 6158593941 |
| NPI Enumeration Date: | 06/07/2006 |
| NPI Last Update Date: | 12/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 0000000149 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |