Organization
CAROL P. LAGRANGE, O.D., P.C.
Active
Other names
Lifetime EyeCare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE PHILLIPS LAYMAN O.D. (OWNER)
(731) 668-3424
Entity
Organization
Contact information
Practice address
2043 GREYSTONE PARK, JACKSON, TN 38305-3575
(731) 668-3424
(731) 668-3425
Mailing address
2043 GREYSTONE PARK, JACKSON, TN 38305-3575
(731) 668-3424
(731) 668-3425
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT831
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0657400001
DMERIC
TN
01
—
28639
BLUE CROSS & BLUE SHIELD
TN
05
—
3596185
—
TN
Enumeration date
07/16/2006
Last updated
08/20/2012
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