Healthcare Provider Details

I. General information

NPI: 1669520433
Provider Name (Legal Business Name): JASON MICHAEL CATES O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 S CEDAR AVE
SOUTH PITTSBURG TN
37380-1303
US

IV. Provider business mailing address

233 S CEDAR AVE
SOUTH PITTSBURG TN
37380-1303
US

V. Phone/Fax

Practice location:
  • Phone: 423-837-8611
  • Fax:
Mailing address:
  • Phone: 423-837-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3731
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: