Healthcare Provider Details

I. General information

NPI: 1164437836
Provider Name (Legal Business Name): ANGELA LEE ANN DABBS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ANGELA LEE ANN SPENCE

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 W MORRIS BLVD
MORRISTOWN TN
37813-2834
US

IV. Provider business mailing address

1760 W MORRIS BLVD
MORRISTOWN TN
37813-2834
US

V. Phone/Fax

Practice location:
  • Phone: 423-581-2020
  • Fax: 423-581-2040
Mailing address:
  • Phone: 423-581-2020
  • Fax: 423-581-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number2663
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: