| |
2145 Jacksboro Pike, La Follette, TN 37766-3003 | |
(423) 562-1531 | |
(423) 562-1724 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 2145 Jacksboro Pike, La Follette, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851505366 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TN1769 (Tennessee) | Primary |
Provider Name | Andrew Wade Howard |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073513081 PECOS PAC ID: 1456415942 Enrollment ID: I20100715000020 |
Provider Name | Elizabeth Thompson Howard |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1285634766 PECOS PAC ID: 8628132115 Enrollment ID: I20100715000053 |
Provider Name | Monica Lyn Perry |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902255326 PECOS PAC ID: 0244523058 Enrollment ID: I20160801000521 |
Mailing Address | Practice Location Address |
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2145 Jacksboro Pike, La Follette, TN 37766-3003 Ph: (423) 562-1531 | 2145 Jacksboro Pike, La Follette, TN 37766-3003 Ph: (423) 562-1531 |