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General NPI Number Information
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NPI Number | 1871656926
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Entity Type | Organization
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Legal Business Name | FAMILY EYE CARE AND PEDIATRIC VISION CENTER, PLLC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 1203 N EASTMAN RD
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City | KINGSPORT
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State | TN
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Zip | 37664-3145
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Country | US
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Telephone | 423-247-3321
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Fax | 423-247-3631
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Provider Business Mailing Address
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Address Line | 1203 N EASTMAN RD
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City | KINGSPORT
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State | TN
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Zip | 37664-3145
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Country | US
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Telephone | 423-247-3321
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Fax | 423-247-3631
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Authorized Official
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Title or Position | CO-OWNER / PLLC MEMBER
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Name | DR. DAVID CORBETT HOLLIMAN
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Credential | OD
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Telephone | 423-247-3321
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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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