MEDICARE: MS. FRANKIE GOOLSBY OD

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	2608	TN

General Provider Information

NPI Number	:	1124104617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRANKIE GOOLSBY OD

Provider Business Mailing Address
First Line	:	PO BOX 2195
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37011-2195
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1341 ROCK SPRINGS RD
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-6108
Country	:	US
Telephone Number	:	615-930-3066
Fax Number	:	615-988-7025

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	01/14/2019

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