Healthcare Provider Details

I. General information

NPI: 1659586758
Provider Name (Legal Business Name): LISA SYKES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7044 CHARLOTTE PIKE
NASHVILLE TN
37209-4210
US

IV. Provider business mailing address

2307 N BERRYS CHAPEL RD
FRANKLIN TN
37069-6602
US

V. Phone/Fax

Practice location:
  • Phone: 615-353-1515
  • Fax:
Mailing address:
  • Phone: 615-791-8015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1588
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: