MEDICARE: MICHAEL R POLITZER O.D.

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
1	152WX0102X	Occupational Vision Optometrist	OD000000538	TN
2	152WL0500X	Low Vision Rehabilitation Optometrist	OD000000538	TN
3	152W00000X	Optometrist	OD000000538	TN
4	152WV0400X	Vision Therapy Optometrist	OD000000538	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	410048955	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4247110001	OTHER	TN	PALMETTO GBA
4	4176259	OTHER	TN	BLUE CROSS BLUE SHIELD
5	2240252	OTHER	TN	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1922091354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL R POLITZER O.D.

Provider Business Mailing Address
First Line	:	144 TIMBERLINE DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7170
Country	:	US
Telephone Number	:	615-330-3895
Fax Number	:

Provider Business Practice Location Address
First Line	:	144 TIMBERLINE DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7170
Country	:	US
Telephone Number	:	615-330-3895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	03/17/2018

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Directions to “ MICHAEL R POLITZER O.D.” Practice Location

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