MEDICARE: DR. FRANK L OGLESBY JR. 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	OD900	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275544041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK L OGLESBY JR. O.D.

Provider Business Mailing Address
First Line	:	1599 FORT HENRY DR
Second Line	:	SUITE 101
City	:	KINGSPORT
State	:	TN
Zip	:	37664-2535
Country	:	US
Telephone Number	:	423-246-2381
Fax Number	:	423-246-2301

Provider Business Practice Location Address
First Line	:	1599 FORT HENRY DR
Second Line	:	SUITE 101
City	:	KINGSPORT
State	:	TN
Zip	:	37664-2535
Country	:	US
Telephone Number	:	423-246-2381
Fax Number	:	423-246-2301

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	10/10/2011

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