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NPI Code Detail

MEDICARE: CLEVELAND EYE CLINIC, PC

MEDICARE: CLEVELAND EYE CLINIC, PC
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
1207W00000XOphthalmology Physician

General Provider Information

NPI Number : 1063465292
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND EYE CLINIC, PC
Provider Business Mailing Address
First Line : 2560 BUSINESS PARK DR NE
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-6503
Country : US
Telephone Number : 423-472-5401
Fax Number : 423-479-3060
Provider Business Practice Location Address
First Line : 2560 BUSINESS PARK DR NE
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-6503
Country : US
Telephone Number : 423-472-5401
Fax Number : 423-479-3060
Authorized Official
Title or Position : PRESIDENT
Name : GREGORY SETH FORD
Credential : MD
Telephone Number : 423-303-1960
Provider Enumeration Date : 05/18/2006
Last Update Date : 06/16/2023

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Directions to “CLEVELAND EYE CLINIC, PC ” Practice Location

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