Organization
NORTHWEST TENNESSEE EYE CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE BROWN (ADMINISTRATOR)
(731) 587-2022
Entity
Organization
Contact information
Practice address
111 HIGHWAY 431, MARTIN, TN 38237-8264
(731) 587-2022
(731) 587-9397
Mailing address
111 HIGHWAY 431, MARTIN, TN 38237-8264
(731) 587-2022
(731) 587-9397
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
TN1767
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3590029
—
TN
01
—
410033713
RAILROAD MEDICARE
TN
Enumeration date
03/23/2007
Last updated
02/05/2024
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