Individual
DONALD W BLOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
605 S BROADWAY, PORTLAND, TN 37148-1619
(615) 325-2020
(615) 325-5862
Mailing address
605 S BROADWAY, P O BOX 470, PORTLAND, TN 37148-1619
(615) 325-2020
(615) 325-5862
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0454
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3595433
—
TN
Enumeration date
05/17/2006
Last updated
02/19/2008
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