Organization
DRS. TIDWELL, FAULKS, AND ALLEN - OPTOMETRY, PLLC
Active
Other names
Drs. Tidwell and Faulks, TIDWELL AND FAULKS, DOCTORS OF OPTOMETRY, PLC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE LEIGH MILLER DO (CERTIFIED INSURANCE TECH AND DATA E)
(615) 446-2020
Entity
Organization
Contact information
Practice address
610 HENSLEE DR, DICKSON, TN 37055-1211
(615) 446-2020
(615) 441-2020
Mailing address
610 HENSLEE DR, DICKSON, TN 37055-1211
(615) 446-2020
(615) 441-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3113988
TIDWELL AND FAULKS BCBST
TN
01
—
3113993
DR JERRY TIDWELL BCBST
TN
01
—
3119266
DR DAVID FAULKS BCBST
TN
01
—
3595690
MEDICARE JERRY TIDWELL
TN
05
—
3595699
—
TN
05
—
3942446
—
TN
01
—
6022728
DR ALLEN BCBST
TN
05
—
Q007418
—
TN
Enumeration date
06/20/2007
Last updated
06/16/2018
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