Organization
LUTTRELL'S EYEWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY G LUTTRELL D. O. (CHIEF MANAGER)
(865) 588-4052
Entity
Organization
Contact information
Practice address
5030 KINGSTON PIKE, KNOXVILLE, TN 37919-5187
(865) 588-4052
Mailing address
5030 KINGSTON PIKE, KNOXVILLE, TN 37919-5187
(865) 588-4052
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1190
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4094205
BLUE CROSS BLUE SHIELD
TN
Enumeration date
11/08/2007
Last updated
06/21/2018
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