MEDICARE: DR. SETH ALEXANDER RHYNE 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	152WP0200X	Pediatric Optometrist	3882	TN
2	152WV0400X	Vision Therapy Optometrist	3882	TN
3	152W00000X	Optometrist	3882	TN

General Provider Information

NPI Number	:	1538901053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SETH ALEXANDER RHYNE OD

Provider Business Mailing Address
First Line	:	715 CALLAHAN DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-1302
Country	:	US
Telephone Number	:	865-437-3166
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 CALLAHAN DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-1302
Country	:	US
Telephone Number	:	865-437-3166
Fax Number	:

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

Provider Enumeration Date	:	06/07/2024
Last Update Date	:	06/07/2024

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