Organization
NORMAN REGIONAL EYE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES RANDALL NORMAN M.D. (PRESIDENT)
(972) 804-4690
Entity
Organization
Contact information
Practice address
125 S JEFFERSON AVE, COOKEVILLE, TN 38501-3424
(972) 804-4690
Mailing address
125 S JEFFERSON AVE, COOKEVILLE, TN 38501-3424
(972) 804-4690
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0000020783
TN
Other
Enumeration date
11/11/2011
Last updated
12/15/2015
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