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Organization

EYE CARE GROUP, PLLC

Active
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Organization

EYE CARE GROUP, PLLC

Active
Parent organization
EYE CARE GROUP, PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
EYE CARE GROUP, PLLC
Authorized official
DR. PHILLIP EARL AGEE O D (CHIEF MANAGER)
(731) 784-1186
Entity
Organization

Contact information

Practice address
2439 N CENTRAL AVE, HUMBOLDT, TN 38343-1753
(731) 784-1186
(731) 784-8228
Mailing address
PO BOX 509, HUMBOLDT, TN 38343-0509
(731) 784-1186
(731) 784-8228

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4105755
BLUE CROSS BLUE SHIELD
TN
Enumeration date
07/17/2006
Last updated
05/15/2008
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