Organization
WILSON COUNTY EYE SURGERY CENTER, LLC
Active
Other names
WILSON COUNTY ANESTHESIA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIVIAN L RAGSDALE (BILLING MANAGER)
(615) 453-5155
Entity
Organization
Contact information
Practice address
1670 W MAIN ST, SUITE 120, LEBANON, TN 37087-1344
(615) 453-5155
(615) 444-5915
Mailing address
1670 W MAIN ST, SUITE 120, LEBANON, TN 37087-1344
(615) 453-5155
(615) 444-5915
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3629275
—
TN
01
—
4085359
BLUE CROSS BLUE SHIELD
TN
01
—
408685534
TRICARE
TN
01
—
408700333
TRICARE
TN
01
—
4091648
BLUE CROSS BLUE SHIELD
TN
01
—
CH7739
RRMEDICARE
TN
01
—
P00228559
RRMEDICARE
TN
01
—
P00235135
RRMEDICARE
TN
Enumeration date
03/14/2007
Last updated
02/02/2009
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