Individual
DR. TOMMY J. DUCKLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2114 ELLISTON PL., NASHVILLE, TN 37203
(615) 329-0000
(615) 327-2431
Mailing address
2114 ELLISTON PL., NASHVILLE, TN 37203
(615) 329-0000
(615) 327-2431
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0696
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008478
BLUECROSS/BLUESHIELD
TN
05
—
3594535
—
TN
01
—
410009236
RAILROAD MEDICARE
TN
01
—
620947940
CIGNA HEALTHCARE
TN
Enumeration date
09/06/2006
Last updated
06/10/2013
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