Healthcare Provider Details

I. General information

NPI: 1437090529
Provider Name (Legal Business Name): COOKEVILLE EYE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E BOCKMAN WAY
SPARTA TN
38583-2036
US

IV. Provider business mailing address

126 E BOCKMAN WAY
SPARTA TN
38583-2036
US

V. Phone/Fax

Practice location:
  • Phone: 931-836-2265
  • Fax: 931-836-3036
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: HEATHER MILLER
Title or Position: DIRECTOR RCM INTEGRATION
Credential:
Phone: 314-682-9854