Organization Name: | EYE CENTERS OF TENNESSEE, LLC |
NPI Number: | 1104940790 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAYMOND K MAYS (ADMINISTRATOR) |
Mailing Address: | 15 Iris Ln Crossville |
State: | TN US |
Postal Code: | 385557528 |
Phone Number: | 9314562728 |
Fax Number: | 9314565446 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 04/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |