Organization
LEBANON EYE ASSOCIATES PC
Active
Other names
THE EYE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN L RAGSDALE (BILLING MANAGER)
(615) 453-5155
Entity
Organization
Contact information
Practice address
1670 W MAIN ST, STE 100, LEBANON, TN 37087-1344
(615) 453-5155
Mailing address
1670 W MAIN ST, STE 100, LEBANON, TN 37087-1344
(615) 453-5155
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1238610001
DMERC SUPPLIER
TN
05
—
3942116
—
TN
01
—
CL3416
PALMETTO-GBA MEDICARE
TN
Enumeration date
04/17/2007
Last updated
02/02/2009
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