Individual
DR. KRISTINA MARIE HAWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1245 MADISON AVENUE, MEMPHIS, TN 38104-2222
(901) 722-3395
Mailing address
1245 MADISON AVENUE, MEMPHIS, TN 38104-2222
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3259
TN
152W00000X
Optometrist
4023 T
OR
152W00000X
Optometrist
5757/T2671
OH
152W00000X
Optometrist
ODP-898
ID
152W00000X
Optometrist
OPT 10079 TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0100790
—
CA
Enumeration date
10/26/2005
Last updated
03/24/2017
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