MEDICARE: UNIVERSITY EYE SPECIALISTS, P.C.

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	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	MD0000019495	TN
2	152WC0802X	Corneal and Contact Management Optometrist
3	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1821153768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY EYE SPECIALISTS, P.C.

Provider Business Mailing Address
First Line	:	1932 ALCOA HWY
Second Line	:	SUITE 255
City	:	KNOXVILLE
State	:	TN
Zip	:	37920
Country	:	US
Telephone Number	:	865-244-2020
Fax Number	:	865-410-7292

Provider Business Practice Location Address
First Line	:	140 CAPITOL DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3343
Country	:	US
Telephone Number	:	865-539-6052
Fax Number	:	865-539-6269

Authorized Official
Title or Position	:	CEO
Name	:	WILL PITT
Credential	:
Telephone Number	:	865-244-2020

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	06/05/2017

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