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General NPI Number Information
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NPI Number | 1861788606
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Entity Type | Organization
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Legal Business Name | TOTAL EYECARE OF EAST TN CORP
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 7420 CHAPMAN HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920-6614
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Country | US
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Telephone | 865-609-1160
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Fax | 865-609-1157
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Provider Business Mailing Address
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Address Line | 7420 CHAPMAN HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920-6614
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Country | US
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Telephone | 865-609-1160
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Fax | 865-609-1157
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. BENJAMIN HERRING
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Credential | O.D.
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Telephone | 865-609-1160
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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 | 2935
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License Number State | TN
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