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Individual

MIKE HASSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
605 MAIN ST N, CARTHAGE, TN 37030-1211
(615) 735-2020
(615) 735-9098
Mailing address
PO BOX 116, CARTHAGE, TN 37030-0116
(615) 735-2020
(615) 735-9098

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000000889
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040299
BLUE CROSS BLUE SHIELD
TN
05
3595240
TN
Enumeration date
05/10/2006
Last updated
07/22/2010
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