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Individual

HENRY G MCQUIRTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342
Mailing address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000000893
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00087053
MS
01
200683
WELLCARE
TN
05
3595398
TN
01
4111863
BCBS
01
5099554
AETNA
01
925130
BLOCK VISION
01
P00279229
RR MEDICARE
TN
Enumeration date
06/08/2006
Last updated
04/01/2021
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