Organization
ASSOCIATES IN EYE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY WALTER UPCHURCH OD (PRESIDENT AND AUTHORIZED OFFICIAL)
(606) 387-5612
Entity
Organization
Contact information
Practice address
2523 JACKSBORO PK, JACKSBORO, TN 37757-4847
(423) 566-2020
(423) 566-4245
Mailing address
PO BOX 306, FERGUSON, KY 42533-0306
(606) 492-2211
(606) 676-0873
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174791
BCBSTN/BLUECARE/TENNCARE
TN
05
—
3941347
—
TN
01
—
3941367; 3941363
MEDICARE PIN FOR DR. KEVIN MYSLIWIEC
TN
01
—
3942271
MEDICAID # FOR DR. SANDY MYSLIWIEC
TN
01
—
62081
OPTUMHEALTH VISION
—
01
—
CJ5379
RAILROAD MEDICARE
TN
01
—
CO0230:012
EYEMED
—
Enumeration date
09/27/2006
Last updated
03/22/2021
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