Organization
EYE CENTERS OF TENNESSEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA D BREEDING (FRONT OFFICE CREDENTIALING)
(931) 456-2728
Entity
Organization
Contact information
Practice address
768 S WILLOW AVE STE A, COOKEVILLE, TN 38501-3892
(931) 528-1567
(931) 528-6094
Mailing address
15 IRIS LN, CROSSVILLE, TN 38555-7528
(931) 456-2728
(931) 456-5446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
156FX1800X
Optician
—
—
207W00000X
Ophthalmology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
OD723
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3724246
—
TN
Enumeration date
03/19/2007
Last updated
04/26/2021
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