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General NPI Number Information
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NPI Number | 1386227239
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Entity Type | Individual
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Provider Name | MALENA LANDON ERICKSON OD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2021
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 600 E VETERANS DR
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City | COOKEVILLE
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State | TN
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Zip | 38501-4038
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Country | US
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Telephone | 931-372-1994
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Fax |
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Provider Business Mailing Address
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Address Line | 3466 MANASSAS RD
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City | COOKEVILLE
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State | TN
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Zip | 38506-6332
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Country | US
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Telephone | 615-719-3534
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT.0003678
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3941
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License Number State | TN
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