Organization
WILSON COUNTY EYE SURGERY CENTER, LLC
Active
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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