Organization
MODERN EYE GALLERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KIRBY (SOLE MBR)
(615) 450-0050
Entity
Organization
Contact information
Practice address
12904 LEBANON RD, MOUNT JULIET, TN 37122-2865
(615) 450-0050
Mailing address
12904 LEBANON RD, MOUNT JULIET, TN 37122-2865
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 2759
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523521
—
TN
Enumeration date
06/10/2016
Last updated
06/10/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up