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General NPI Number Information
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NPI Number | 1417439027
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Entity Type | Organization
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Legal Business Name | VISIONCARE OF BRENTWOOD INC.
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 780 OLD HICKORY BLVD
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City | BRENTWOOD
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State | TN
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Zip | 37027-4527
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Country | US
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Telephone | 615-373-8496
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Fax | 615-373-8482
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Provider Business Mailing Address
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Address Line | 4761 ANDREW JACKSON PKWY STE 108
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City | HERMITAGE
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State | TN
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Zip | 37076-1354
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Country | US
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Telephone | 615-891-1243
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Fax | 615-891-1254
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CHASE TERRELL PARKER
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Credential | OD
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Telephone | 615-373-8496
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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 | 3041
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License Number State | TN
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