# KINGSPORT TN OPHTHALMOLOGY ASC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Regional Eye Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649244211
- **Authorized official:** MR. JEFFREY SNODGRASS (PRESIDENT)
- **Authorized official phone:** (615) 665-1283

## Contact information

- **Practice address:** 999 EXECUTIVE PARK BLVD, SUITE 100, KINGSPORT, TN 37660-4632
- **Practice address phone:** (423) 247-2022
- **Practice address fax:** (423) 247-2027
- **Mailing address:** 1A BURTON HILLS BLVD STE 300, NASHVILLE, TN 37215-6153
- **Mailing address phone:** (615) 263-4011
- **Mailing address fax:** (615) 234-1720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0000000158 | TN | Yes |

## Other

- **Enumeration date:** 02/13/2006
- **Last updated:** 08/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3288818 | — | TN |
| 01 | — | P00057294 | MEDICARE RAILROAD | TN |