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Individual

STUART SULLINS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
517 N JACKSON ST, ATHENS, TN 37303-3621
(423) 745-4910
(423) 742-2230
Mailing address
517 N JACKSON ST, ATHENS, TN 37303-3621
(423) 745-4910
(423) 742-2230

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000001899
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3101119
TN
Enumeration date
06/24/2005
Last updated
07/08/2007
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