Organization
MBC INC
Active
Other names
Persell Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESLEY ONEAL PERSELL O.D. (OWNER)
(901) 466-1333
Entity
Organization
Contact information
Practice address
7085 HIGHWAY 64, SUITE 2, OAKLAND, TN 38060-3366
(901) 466-1333
(901) 466-1333
Mailing address
7085 HIGHWAY 64, SUITE 2, OAKLAND, TN 38060-3366
(901) 466-1333
(901) 466-1333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2443
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4126391
BLUE CROSS BLUE SHIELD
TN
05
—
4126391
—
TN
Enumeration date
01/25/2007
Last updated
01/24/2008
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