Healthcare Provider Details

I. General information

NPI: 1114043189
Provider Name (Legal Business Name): OPTOMETRY UNLIMITED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 02/14/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5429 EDMONDSON PIKE
NASHVILLE TN
37211
US

IV. Provider business mailing address

5429 EDMONDSON PIKE
NASHVILLE TN
37211-5869
US

V. Phone/Fax

Practice location:
  • Phone: 615-331-8688
  • Fax: 615-457-8964
Mailing address:
  • Phone: 615-331-8688
  • Fax: 615-457-8964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. CHALMERS WADE HYATT III
Title or Position: TAX MATTERS MEMBER
Credential: O.D.
Phone: 615-331-8688