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General NPI Number Information
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NPI Number | 1356717573
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Entity Type | Organization
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Legal Business Name | SHERRILL FAMILY EYECARE, PLLC
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Dates
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Enumeration Date | 08/12/2015
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 373 S ILLINOIS AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6741
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Country | US
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Telephone | 865-224-6434
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Fax | 865-268-4476
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Provider Business Mailing Address
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Address Line | 373 S ILLINOIS AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6741
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Country | US
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Telephone | 865-224-6434
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Fax | 865-268-4476
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Authorized Official
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Title or Position | MANAGING MEMBER/OPTOMETRIST
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Name | DR. FORREST LANDON SHERRILL
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Credential | OD
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Telephone | 865-224-6434
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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 | 3224
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License Number State | TN
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