Organization
SOUTHERN COLLEGE OF OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E VENABLE OD (VICE PRESIDENT OF CLINICAL OP)
(901) 722-3324
Entity
Organization
Contact information
Practice address
1225 MADISON AVE, MEMPHIS, TN 38104-2211
(901) 722-3250
(901) 722-3347
Mailing address
1245 MADISON AVE, MEMPHIS, TN 38104-2211
(901) 722-3250
(901) 722-3347
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3517680
—
TN
Enumeration date
08/24/2005
Last updated
07/19/2013
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