Organization
RETINA CONSULTANTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM DAVID IRVINE M.D. (PRESIDENT)
(731) 668-3161
Entity
Organization
Contact information
Practice address
1000 VANN DR, SUITE A, JACKSON, TN 38305-6055
(731) 668-3161
(731) 668-3162
Mailing address
1000 VANN DR, SUITE A, JACKSON, TN 38305-6055
(731) 668-3161
(731) 668-3162
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD024247
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG2147
RAILROAD MEDICARE
TN
Enumeration date
09/06/2006
Last updated
12/17/2007
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