Healthcare Provider Details

I. General information

NPI: 1548302854
Provider Name (Legal Business Name): DONELSON EYECARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2378 LEBANON PIKE
NASHVILLE TN
37214-2411
US

IV. Provider business mailing address

3252 ASPEN GROVE DR STE 1
FRANKLIN TN
37067-4894
US

V. Phone/Fax

Practice location:
  • Phone: 615-889-0147
  • Fax: 615-889-2700
Mailing address:
  • Phone: 615-786-9044
  • Fax: 615-905-4655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1459
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JEFFREY L KEGARISE
Title or Position: PRESIDENT
Credential: OD
Phone: 615-771-7555