Individual
MR. JOSEPH LEE EDMISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
614 CUMBERLAND HILLS DR, HENDERSONVILLE, TN 37075-4374
(615) 822-5381
Mailing address
614 CUMBERLAND HILLS DR, HENDERSONVILLE, TN 37075-4374
(615) 826-1611
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
777
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69274
BLUE CROSS BLUE SHEILD
TN
05
—
69274
—
TN
Enumeration date
02/12/2007
Last updated
07/02/2018
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