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NPI Code Detail

MEDICARE: CATARACT AND LASER CENTER, LLC

MEDICARE: CATARACT AND LASER CENTER, LLC
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
1261QS0132XOphthalmologic Surgery Clinic/Center0000000130TN

Other Identifiers

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

General Provider Information

NPI Number : 1568431054
Entity Type Code : Organization
Provider Name (Legal Business Name) : CATARACT AND LASER CENTER, LLC
Provider Business Mailing Address
First Line : 15 IRIS LN
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-7528
Country : US
Telephone Number : 931-707-0704
Fax Number : 931-707-7493
Provider Business Practice Location Address
First Line : 15 IRIS LN
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-7528
Country : US
Telephone Number : 931-707-0704
Fax Number : 931-707-7493
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : JONEL PHIPPS
Credential :
Telephone Number : 931-456-2728
Provider Enumeration Date : 03/16/2006
Last Update Date : 06/02/2023

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Directions to “CATARACT AND LASER CENTER, LLC ” Practice Location

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