Individual
DR. JAMES L DUCKLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5252 HICKORY HOLLOW PKWY, SUITE 1133, ANTIOCH, TN 37013-3005
(615) 731-6230
(615) 731-6538
Mailing address
5252 HICKORY HOLLOW PKWY, SUITE 1133, ANTIOCH, TN 37013-3005
(615) 731-6230
(615) 731-6538
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT 1233
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118062
BLUE CROSS BLUE SHIELD
TN
05
—
3597450
—
TN
01
—
621429478
PRIVATE HEALTH CARE SYSTE
TN
Enumeration date
06/05/2006
Last updated
09/22/2009
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