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General NPI Number Information
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NPI Number | 1518961176
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Entity Type | Organization
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Legal Business Name | SOUTHEAST EYE SPECIALISTS PLLC
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 7268 JARNIGAN RD SUITE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3097
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Country | US
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Telephone | 423-508-7337
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Fax | 423-508-7338
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Provider Business Mailing Address
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Address Line | 341 COOL SPRINGS BLVD STE 220
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City | FRANKLIN
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State | TN
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Zip | 37067-4650
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Country | US
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Telephone | 423-508-7337
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Fax | 423-508-7338
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR, REVENUE CYCLE
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Name | THOMAS R ZDRALE
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Credential |
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Telephone | 724-713-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0120X
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Taxonomy Name | Cornea and External Diseases Specialist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207WX0110X
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Taxonomy Name | Pediatric Ophthalmology and Strabismus Specialist Physician Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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