Leslie Dehaven, OD | |
122 Highway 76, White House, TN 37188-9291 | |
(615) 672-6896 | |
(615) 672-6783 |
Full Name | Leslie Dehaven |
---|---|
Gender | Female |
Speciality | Optometrist |
Location | 122 Highway 76, White House, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114081106 | NPI | - | NPPES |
3944682 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2276 (Tennessee) | Primary |
152W00000X | Optometrist | 1510DT (Kentucky) | Secondary |
Provider Name | Hank Dehaven |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790793495 PECOS PAC ID: 3577524925 Enrollment ID: I20050929001329 |
Mailing Address | Practice Location Address |
---|---|
Leslie Dehaven, OD 122 Highway 76, White House, TN 37188-9291 Ph: (615) 672-6896 | Leslie Dehaven, OD 122 Highway 76, White House, TN 37188-9291 Ph: (615) 672-6896 |
Clear Sight Eye Center Optometrist Medicare: Not Enrolled in Medicare Practice Location: 222 Wilkinson Ln, White House, TN 37188 Phone: 615-672-3312 Fax: 615-672-9278 | |
Dr. Hank D Dehaven, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 122 Highway 76, White House, TN 37188 Phone: 615-672-6896 Fax: 615-672-6783 | |
Mr. Ralph W. Simonton Iii, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2823 Highway 31 W. South, White House, TN 37188 Phone: 615-672-4683 Fax: 615-672-4643 |