MEDICARE: DR. TRACY WINTON PATTON O.D.

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	TN2762	TN

General Provider Information

NPI Number	:	1902095581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACY WINTON PATTON O.D.

Provider Business Mailing Address
First Line	:	524B DONELSON PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3729
Country	:	US
Telephone Number	:	615-889-0147
Fax Number	:	615-889-2700

Provider Business Practice Location Address
First Line	:	524B DONELSON PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3729
Country	:	US
Telephone Number	:	615-889-0147
Fax Number	:	615-889-2700

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

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	06/14/2012

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