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
2300 AMANDA AVE, DYERSBURG, TN 38024-1961
(731) 286-1002
(731) 286-6231
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
07/02/2006
Last updated
05/15/2008
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