Organization
LEBANON EYE ASSOCSTONES RIVER
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
511 MEMORIAL BLVD, MURFREESBORO, TN 37129
(615) 453-5155
(615) 444-5915
Mailing address
1670 W MAIN ST, STE 100, LEBANON, TN 37087-1344
(615) 453-5155
(615) 444-5915
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1520
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003288
TENNCARE SELECT
TN
Enumeration date
05/03/2007
Last updated
02/02/2009
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