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General NPI Number Information
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NPI Number | 1962588160
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Entity Type | Organization
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Legal Business Name | THE EYE SURGERY CENTER OF OAK RIDGE LLC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 90 VERMONT AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830
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Country | US
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Telephone | 865-482-8894
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Fax | 865-481-8349
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Provider Business Mailing Address
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Address Line | 90 VERMONT AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830
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Country | US
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Telephone | 865-482-8894
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Fax | 865-481-8349
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Authorized Official
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Title or Position | PRESIDENT PARTNER
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Name | DR. ROBERT E WALKER
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Credential | MD
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Telephone | 865-482-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0000000078
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License Number State | TN
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