Individual
DR. TERRY WAYNE CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
915 N CHANCERY ST, STE 120, MC MINNVILLE, TN 37110-1504
(931) 473-0890
Mailing address
312 N CHANCERY ST, MCMINNVILLE, TN 37110-2048
(931) 473-0890
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1737
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3941010
—
TN
01
—
4006004
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
07/26/2006
Last updated
04/23/2020
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