Healthcare Provider Details

I. General information

NPI: 1922091354
Provider Name (Legal Business Name): MICHAEL R POLITZER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 TIMBERLINE DR
FRANKLIN TN
37069-7170
US

IV. Provider business mailing address

144 TIMBERLINE DR
FRANKLIN TN
37069-7170
US

V. Phone/Fax

Practice location:
  • Phone: 615-330-3895
  • Fax:
Mailing address:
  • Phone: 615-330-3895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD000000538
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOD000000538
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberOD000000538
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License NumberOD000000538
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: