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Organization

STEWART SHOFNER MD PC

Active
Other names
Shofner Vision Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICIA WHITESIDE (PRACTICE ADMINISTRATOR)
(615) 340-4733
Entity
Organization

Contact information

Practice address
2021 CHURCH ST, SUITE 300, NASHVILLE, TN 37203-2021
(615) 340-4733
(615) 340-4734
Mailing address
2021 CHURCH ST, SUITE 300, NASHVILLE, TN 37203-2021
(615) 340-4733
(615) 340-4734

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20369
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0102059
BCBST
TN
01
01055839
AMERIGROUP
TN
01
3050851
MEDICARE PIN
TN
01
4402408
AETNA
TN
01
P00116360
RAILROAD MEDICARE
TN
Enumeration date
09/01/2010
Last updated
05/22/2014
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