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General NPI Number Information
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NPI Number | 1265632301
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Entity Type | Organization
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Legal Business Name | WINCHESTER EYE CLINIC P.C.
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 183 HOSPITAL RD SUITE H
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City | WINCHESTER
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State | TN
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Zip | 37398-6207
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Country | US
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Telephone | 931-967-2230
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Fax | 931-967-9622
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Provider Business Mailing Address
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Address Line | 183 HOSPITAL RD SUITE H
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City | WINCHESTER
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State | TN
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Zip | 37398-2470
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Country | US
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Telephone | 931-967-2230
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Fax | 931-967-9622
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM MARLIN HICKS
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Credential | O.D.
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Telephone | 931-967-2230
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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 | 0000000494
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License Number State | TN
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