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Organization

JAMES L DUCKLO OD

Active
Other names
James L Ducklo Od and Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DAWN WILLIAMS (OFFICE MANAGER)
(615) 731-6230
Entity
Organization

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
ODT1233
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0118062
BLUE CROSS BLUE SHIELD
TN
01
5697119
FIRST HEALTH
TN
01
TN1233
EYEMED
TN
Enumeration date
01/18/2007
Last updated
09/22/2009
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