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Individual

DR. WILLIAM DAVID SULLINS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
517 N JACKSON ST, ATHENS, TN 37303-3621
(423) 745-4910
(423) 745-2230
Mailing address
517 N JACKSON ST, ATHENS, TN 37303-3621
(423) 745-4910
(423) 745-2230

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T1722
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3064008
TN
Enumeration date
06/21/2005
Last updated
01/12/2010
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