Healthcare Provider Details

I. General information

NPI: 1558539759
Provider Name (Legal Business Name): CENTER OF VISION DEVELOPMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 NEAL ST SUITE 300
COOKEVILLE TN
38501-0942
US

IV. Provider business mailing address

1080 NEAL ST SUITE 300
COOKEVILLE TN
38501-0942
US

V. Phone/Fax

Practice location:
  • Phone: 931-372-2567
  • Fax:
Mailing address:
  • Phone: 931-372-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberODT2014
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberODT2014
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberODT2014
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License NumberODT2014
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberODT2014
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License NumberODT2014
License Number StateTN
# 7
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODT2014
License Number StateTN

VIII. Authorized Official

Name: DR. JASON C CLOPTON
Title or Position: OWNER
Credential: O.D.
Phone: 931-372-2567