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NPI Code Detail

MEDICARE: CAITLIN JAN FOLLANSBEE OD

MEDICARE: CAITLIN JAN FOLLANSBEE OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3619TN

General Provider Information

NPI Number : 1144838137
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN JAN FOLLANSBEE OD
Provider Business Mailing Address
First Line : 2101 FORT HENRY DR
Second Line : SPC E-9
City : KINGSPORT
State : TN
Zip : 37664-3658
Country : US
Telephone Number : 901-604-3063
Fax Number :
Provider Business Practice Location Address
First Line : 2011 N ROAN ST
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-3130
Country : US
Telephone Number : 423-610-7155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2020
Last Update Date : 08/04/2020

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Directions to “ CAITLIN JAN FOLLANSBEE OD” Practice Location

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