Organization
LARRY LEE NICHOLSON II OD
Active
Other names
Huntingdon Eye Care, PC
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LEE NICHOLSON II OD O.D. (OWNER CORPORATION PRESIDENT)
(731) 986-4400
Entity
Organization
Contact information
Practice address
19870 MAIN ST E, HUNTINGDON, TN 38344-3927
(731) 986-4400
(731) 986-7981
Mailing address
19870 MAIN ST E, HUNTINGDON, TN 38344-3927
(731) 986-4400
(731) 986-7981
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3946177
MEDICARE INDIVIUAL
TN
01
—
DB9347
RAILROAD MEDICARE
TN
Enumeration date
06/12/2006
Last updated
10/02/2013
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