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General NPI Number Information
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NPI Number | 1376886887
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Entity Type | Organization
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Legal Business Name | REEVES EYE SURGERY CENTER LLC
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 2328 KNOB CREEK RD SUITE 500
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City | JOHNSON CITY
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State | TN
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Zip | 37604
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Country | US
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Telephone | 423-722-1310
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Fax | 423-926-0529
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Provider Business Mailing Address
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Address Line | 2328 KNOB CREEK RD SUITE 500
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City | JOHNSON CITY
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State | TN
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Zip | 37604
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Country | US
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Telephone | 423-722-1310
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Fax | 423-926-0529
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONNY L REEVES
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Credential | MD
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Telephone | 423-722-1311
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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 | 38547
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License Number State | TN
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