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General NPI Number Information
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NPI Number | 1851152565
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Entity Type | Organization
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Legal Business Name | EAGLE EYECARE PLLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 02/25/2024
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Provider Practice Location Address
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Address Line | 3035 HAMILTON CHURCH RD
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City | ANTIOCH
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State | TN
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Zip | 37013-1429
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Country | US
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Telephone | 615-705-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 3035 HAMILTON CHURCH RD
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City | ANTIOCH
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State | TN
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Zip | 37013-1429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. AMGAD MIKHAEIL
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Credential | OD
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Telephone | 615-720-8698
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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 |
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License Number State |
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