Organization
EYE CARE GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDY H LEWIS O D (CHIEF MANAGER)
(731) 784-1186
Entity
Organization
Contact information
Practice address
2439 N CENTRAL AVE, HUMBOLDT, TN 38343-1753
(731) 784-1186
(731) 784-8228
Mailing address
PO BOX 509, HUMBOLDT, TN 38343-0509
(731) 784-1186
(731) 784-8228
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3729980
—
TN
01
—
4105755
BLUE CROSS BLUE SHIELD
TN
01
—
5466560001
MEDICARE DMEPOS
TN
01
—
5466560002
MEDICARE DMEPOS
TN
01
—
5466560003
MEDICARE DMEPOS
TN
01
—
5466560004
MEDICARE DMEPOS
TN
Enumeration date
06/25/2006
Last updated
09/11/2015
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