Healthcare Provider Details

I. General information

NPI: 1134282163
Provider Name (Legal Business Name): 2001 VISION CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4678 KNIGHT ARNOLD RD
MEMPHIS TN
38118
US

IV. Provider business mailing address

4678 KNIGHT ARNOLD RD
MEMPHIS TN
38118
US

V. Phone/Fax

Practice location:
  • Phone: 901-363-2001
  • Fax: 901-367-9355
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY B ROGERS
Title or Position: CORPORATE SECRETARY 2001 VISION CEN
Credential:
Phone: 901-363-2001