MEDICARE: WEST TENNESSEE EYE PLC

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	1797	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	:	1558423962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST TENNESSEE EYE PLC

Provider Business Mailing Address
First Line	:	8120 US HIGHWAY 51 N STE 6
Second Line	:
City	:	MILLINGTON
State	:	TN
Zip	:	38053-1702
Country	:	US
Telephone Number	:	901-872-2020
Fax Number	:	901-873-1199

Provider Business Practice Location Address
First Line	:	8120 US HIGHWAY 51 N STE 6
Second Line	:
City	:	MILLINGTON
State	:	TN
Zip	:	38053-1702
Country	:	US
Telephone Number	:	901-872-2020
Fax Number	:	901-873-1199

Authorized Official
Title or Position	:	BILLING AND CREDENTIALING MANAGER
Name	:	PATRICIA PARKS
Credential	:
Telephone Number	:	517-231-4086

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	02/03/2026

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Directions to “WEST TENNESSEE EYE PLC ” Practice Location

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