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General NPI Number Information
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NPI Number | 1285592816
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Entity Type | Organization
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Legal Business Name | EYEDEAL SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3185 W STATE ST STE 2020
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City | BRISTOL
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State | TN
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Zip | 37620-1600
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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 | 450 DOUGLAS CHAPEL RD
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City | JONESBOROUGH
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State | TN
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Zip | 37659-3547
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JOSHUA HICKS
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Credential | MD
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Telephone | 336-407-1941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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