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General NPI Number Information
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NPI Number | 1235265901
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Entity Type | Organization
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Legal Business Name | DR. D. WINSTON THAXTON 111
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 4301 HILLSBORO PIKE 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 | 615-297-7576
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Provider Business Mailing Address
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Address Line | 4301 HILLSBORO PIKE 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 | 615-297-7576
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DILLARD WINSTON THAXTON II
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Credential | O.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 | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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