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General NPI Number Information
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NPI Number | 1033305735
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Entity Type | Organization
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Legal Business Name | MIDDLE TENNESSEE EYE ASSOCIATES OF COOKEVILLE PLLC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 600 E VETERANS DR SUITE A
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City | COOKEVILLE
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State | TN
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Zip | 38501-4038
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Country | US
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Telephone | 931-372-1994
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Fax | 931-372-9045
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Provider Business Mailing Address
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Address Line | 600 E VETERANS DR SUITE A
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City | COOKEVILLE
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State | TN
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Zip | 38501-4038
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Country | US
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Telephone | 931-372-1994
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Fax | 931-372-9045
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Authorized Official
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Title or Position | OWNER/OPHTHALMOLOGIST
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Name | DR. ALISSA CRAFT HUDSON
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Credential | M.D.
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Telephone | 931-372-1994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD0000040781
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License Number State | TN
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