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General NPI Number Information
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NPI Number | 1245340603
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Entity Type | Organization
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Legal Business Name | MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 3185 W STATE ST SUITE 2020
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City | BRISTOL
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State | TN
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Zip | 37620-1610
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Country | US
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Telephone | 423-968-4141
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Fax | 423-968-7641
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Provider Business Mailing Address
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Address Line | 2010 BREMO RD STE 128A
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City | RICHMOND
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State | VA
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Zip | 23226-2444
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Country | US
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Telephone | 877-969-0392
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AMY BURTON
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Credential |
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Telephone | 434-661-7762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 152
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License Number State | TN
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