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General NPI Number Information
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NPI Number | 1023566809
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Entity Type | Organization
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Legal Business Name | GREEN HILLS EYECARE
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 4301 HILLSBORO PIKE STE 330
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City | NASHVILLE
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State | TN
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Zip | 37215-3345
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Country | US
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Telephone | 615-297-7547
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 HILLSBORO PIKE STE 330
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City | NASHVILLE
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State | TN
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Zip | 37215-3345
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Country | US
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Telephone | 615-297-7547
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA DURHAM
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Credential | M.D.
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Telephone | 615-297-7547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TN2926
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License Number State | TN
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