MEDICARE: FRANK A CARUSONE O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	007017	OH
2	152WS0006X	Sports Vision Optometrist	3296	TN
3	152WV0400X	Vision Therapy Optometrist	3296	TN
4	152W00000X	Optometrist	3296	TN

General Provider Information

NPI Number	:	1053764803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK A CARUSONE O.D.

Provider Business Mailing Address
First Line	:	715 CALLAHAN DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-1302
Country	:	US
Telephone Number	:	865-687-1232
Fax Number	:	865-687-8256

Provider Business Practice Location Address
First Line	:	715 CALLAHAN DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-1302
Country	:	US
Telephone Number	:	865-687-1232
Fax Number	:	865-687-8256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	04/19/2022

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Directions to “ FRANK A CARUSONE O.D.” Practice Location

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