Healthcare Provider Details

I. General information

NPI: 1396781647
Provider Name (Legal Business Name): MEMPHIS EYE AND CATARACT ASSOCIATES PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6485 POPLAR AVE
MEMPHIS TN
38119-4864
US

IV. Provider business mailing address

6485 POPLAR AVE
MEMPHIS TN
38119-4864
US

V. Phone/Fax

Practice location:
  • Phone: 901-767-4407
  • Fax: 901-767-3048
Mailing address:
  • Phone: 901-767-4407
  • Fax: 901-767-3048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. JERRE M FREEMAN
Title or Position: OWNER
Credential: MD
Phone: 901-767-4407