MEDICARE: SOUTHEAST EYE SPECIALISTS PLLC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician
2	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician
3	152W00000X	Optometrist
4	207WX0107X	Retina Specialist (Ophthalmology) Physician
5	207WX0120X	Cornea and External Diseases Specialist Physician
6	363A00000X	Physician Assistant
7	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician
8	207W00000X	Ophthalmology Physician

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1518961176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEAST EYE SPECIALISTS PLLC

Provider Business Mailing Address
First Line	:	341 COOL SPRINGS BLVD STE 220
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-4650
Country	:	US
Telephone Number	:	423-508-7337
Fax Number	:	423-508-7338

Provider Business Practice Location Address
First Line	:	7268 JARNIGAN RD
Second Line	:	SUITE 200
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3097
Country	:	US
Telephone Number	:	423-508-7337
Fax Number	:	423-508-7338

Authorized Official
Title or Position	:	DIRECTOR RCM
Name	:	AMY BURTON
Credential	:
Telephone Number	:	434-661-7762

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	01/30/2026