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Individual

DR. HANK D DEHAVEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
122 HIGHWAY 76, WHITE HOUSE, TN 37188-9291
(615) 672-6896
(615) 672-6783
Mailing address
122 HIGHWAY 76, WHITE HOUSE, TN 37188-9291
(615) 672-6896
(615) 672-6783

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2277
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3945747
TN
01
4108253
BLUE CROSS BLUE SHIELD TN
TN
01
6537319
CIGNA
TN
Enumeration date
08/04/2006
Last updated
07/08/2007
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