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General NPI Number Information
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NPI Number | 1609868363
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Entity Type | Organization
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Legal Business Name | CAMDEN EYE CARE ASSOCIATES
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 264 HIGHWAY 641 N
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City | CAMDEN
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State | TN
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Zip | 38320-1329
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Country | US
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Telephone | 731-584-7942
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Fax | 731-584-7965
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Provider Business Mailing Address
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Address Line | 264 HIGHWAY 641 N
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City | CAMDEN
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State | TN
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Zip | 38320-1329
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Country | US
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Telephone | 731-584-7942
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Fax | 731-584-7965
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. TONYA M REYNOLDSON
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Credential | OD
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Telephone | 731-584-7942
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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 | OD0000002255
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License Number State | TN
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