MEDICARE: COOKEVILLE EYE SPECIALISTS, PLLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1437090529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOKEVILLE EYE SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	126 E BOCKMAN WAY
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-2036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 E BOCKMAN WAY
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-2036
Country	:	US
Telephone Number	:	931-836-2265
Fax Number	:	931-836-3036

Authorized Official
Title or Position	:	DIRECTOR RCM INTEGRATION
Name	:	HEATHER MILLER
Credential	:
Telephone Number	:	314-682-9854

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/15/2026

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