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General NPI Number Information
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NPI Number | 1154504959
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Entity Type | Organization
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Legal Business Name | SMOKY MOUNTAIN EYE CARE P.C.
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 1550 E MORRIS BLVD
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City | MORRISTOWN
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State | TN
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Zip | 37813-2153
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Country | US
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Telephone | 423-585-5857
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Fax | 423-585-5904
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Provider Business Mailing Address
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Address Line | PO BOX 688
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City | MORRISTOWN
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State | TN
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Zip | 37815-0688
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Country | US
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Telephone | 423-585-5857
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Fax | 423-585-5904
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRAD STEPHEN LINDSEY
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Credential | O.D.
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Telephone | 42355855857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OD-1422
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License Number State | TN
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