Organization
HARDEMAN COUNTY VISION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH GAULT LIGON OD (OPTOMETRIST)
(731) 658-5197
Entity
Organization
Contact information
Practice address
725 W MARKET ST, BOLIVAR, TN 38008-2242
(731) 658-5197
(731) 658-5245
Mailing address
215 MEADOW RIDGE DR, LAKELAND, TN 38002-4880
(803) 984-5278
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6051220
BCBS
TN
01
—
7699658
CIGNA
TN
01
—
A22476
EYEMED
TN
05
—
Q015027
—
TN
Enumeration date
02/09/2021
Last updated
02/09/2021
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