Healthcare Provider Details

I. General information

NPI: 1174728729
Provider Name (Legal Business Name): EYE CARE CENTERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N KENTUCKY ST
KINGSTON TN
37763-2629
US

IV. Provider business mailing address

2497 S ROANE ST STE 110
HARRIMAN TN
37748-8670
US

V. Phone/Fax

Practice location:
  • Phone: 865-376-7474
  • Fax: 865-376-7476
Mailing address:
  • Phone: 865-882-7470
  • Fax: 865-882-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN M HUNT
Title or Position: PARTNER
Credential: OD
Phone: 865-376-7474