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General NPI Number Information
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NPI Number | 1568431054
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Entity Type | Organization
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Legal Business Name | CATARACT AND LASER CENTER, LLC
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 15 IRIS LN
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City | CROSSVILLE
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State | TN
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Zip | 38555-7528
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Country | US
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Telephone | 931-707-0704
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Fax | 931-707-7493
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Provider Business Mailing Address
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Address Line | 15 IRIS LN
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City | CROSSVILLE
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State | TN
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Zip | 38555-7528
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Country | US
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Telephone | 931-707-0704
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Fax | 931-707-7493
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | JONEL PHIPPS
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Credential |
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Telephone | 931-456-2728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 0000000130
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License Number State | TN
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