Individual
DR. TOMMY RAY BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1922 SHADY BROOK PLAZA, COLUMBIA, TN 38401-3989
(931) 388-2061
Mailing address
1922 SHADY BROOK PLAZA, COLUMBIA, TN 38401-3989
(931) 388-2061
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1062DT
KY
152W00000X
Optometrist
Primary
ODT940
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4025729
—
TN
Enumeration date
08/09/2006
Last updated
02/19/2008
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