| Southern College Of Optometry | |
|
1225 Madison Ave, Memphis, TN 38104-2211 | |
| (901) 722-3250 | |
| (901) 722-3347 |
| Full Name | Southern College Of Optometry |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1225 Madison Ave, Memphis, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851384986 | NPI | - | NPPES |
| 3517680 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Daniel G Fuller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023087632 PECOS PAC ID: 2860392842 Enrollment ID: I20040113000692 |
| Provider Name | James A Williamson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831183060 PECOS PAC ID: 5698662880 Enrollment ID: I20040302001090 |
| Provider Name | Janette D Dumas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720071913 PECOS PAC ID: 8820986391 Enrollment ID: I20040306000216 |
| Provider Name | James E Venable |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891788956 PECOS PAC ID: 5890685416 Enrollment ID: I20040317001368 |
| Provider Name | Kristopher A May |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598758781 PECOS PAC ID: 3173516523 Enrollment ID: I20040403000188 |
| Provider Name | Michael S Ensor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679501019 PECOS PAC ID: 9830176411 Enrollment ID: I20040701000749 |
| Provider Name | Karmen Holdinghausen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124028097 PECOS PAC ID: 3779558267 Enrollment ID: I20040828000036 |
| Provider Name | John E Linn |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1902853393 PECOS PAC ID: 7618940032 Enrollment ID: I20040903000925 |
| Provider Name | Andrew J Rixon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912990102 PECOS PAC ID: 4688642515 Enrollment ID: I20040920000304 |
| Provider Name | Michael Dorkowski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114963683 PECOS PAC ID: 7911941265 Enrollment ID: I20050616001028 |
| Provider Name | Jason D Duncan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881687077 PECOS PAC ID: 2567476344 Enrollment ID: I20060131000932 |
| Provider Name | Patricia E Walker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386696201 PECOS PAC ID: 7517978687 Enrollment ID: I20060606000219 |
| Provider Name | Richard S Savoy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376523142 PECOS PAC ID: 7911000781 Enrollment ID: I20070315000234 |
| Provider Name | Jennifer Sanderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659441269 PECOS PAC ID: 3173621356 Enrollment ID: I20070612000446 |
| Provider Name | Marc B Taub |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275754020 PECOS PAC ID: 2567490931 Enrollment ID: I20070817000359 |
| Provider Name | Jennifer L Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235338658 PECOS PAC ID: 3870682263 Enrollment ID: I20071207000848 |
| Provider Name | Cynthia Heard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063463941 PECOS PAC ID: 8628096096 Enrollment ID: I20080218000063 |
| Provider Name | Glenn I Goldring |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073532693 PECOS PAC ID: 2567548456 Enrollment ID: I20080318000260 |
| Provider Name | Artee Nanji |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164568358 PECOS PAC ID: 9739254574 Enrollment ID: I20080813000781 |
| Provider Name | Lindsay Elkins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114181096 PECOS PAC ID: 0749355105 Enrollment ID: I20080819000767 |
| Provider Name | Cheryl Ervin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811980097 PECOS PAC ID: 2466511076 Enrollment ID: I20081111000287 |
| Provider Name | Bernard Sparks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336132497 PECOS PAC ID: 5395820658 Enrollment ID: I20081122000080 |
| Provider Name | Patricia Cisarik |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508869009 PECOS PAC ID: 0941218622 Enrollment ID: I20090512000666 |
| Provider Name | John Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992798193 PECOS PAC ID: 6709924830 Enrollment ID: I20091111000174 |
| Provider Name | William Edmondson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679592679 PECOS PAC ID: 7911894860 Enrollment ID: I20100119000459 |
| Provider Name | Michael Daniel Gerstner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215920350 PECOS PAC ID: 0749498996 Enrollment ID: I20101011000306 |
| Provider Name | Sylvia Elizabeth Sparrow |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265425458 PECOS PAC ID: 8325230964 Enrollment ID: I20101014000337 |
| Provider Name | Jared Thomas Powelson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992798185 PECOS PAC ID: 8921216177 Enrollment ID: I20101015000084 |
| Provider Name | John Bart Campbell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144213331 PECOS PAC ID: 3971796426 Enrollment ID: I20101018000435 |
| Provider Name | Aaron Kerr |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972596161 PECOS PAC ID: 6608060173 Enrollment ID: I20101028000592 |
| Provider Name | Christopher William Lievens |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912990086 PECOS PAC ID: 7810181302 Enrollment ID: I20101028000810 |
| Provider Name | Angela Howell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932179942 PECOS PAC ID: 7911913207 Enrollment ID: I20101119000041 |
| Provider Name | Christina Newman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417140708 PECOS PAC ID: 3870789621 Enrollment ID: I20101119000223 |
| Provider Name | Glen T Steele |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568455749 PECOS PAC ID: 6002002516 Enrollment ID: I20101123000799 |
| Provider Name | Paul Alan Harris |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689765786 PECOS PAC ID: 8224181896 Enrollment ID: I20110127000676 |
| Provider Name | Christina F Miller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598906026 PECOS PAC ID: 7315127818 Enrollment ID: I20110215000511 |
| Provider Name | Wilson Walter Mcgriff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851602114 PECOS PAC ID: 3971796129 Enrollment ID: I20110906000492 |
| Provider Name | Esla Subashi Speth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033424437 PECOS PAC ID: 7315108784 Enrollment ID: I20120411000405 |
| Provider Name | Do Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407114663 PECOS PAC ID: 8325203748 Enrollment ID: I20120709000578 |
| Provider Name | Pamela Schnell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992871214 PECOS PAC ID: 4183769557 Enrollment ID: I20120725000542 |
| Provider Name | Melissa Zarn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487884359 PECOS PAC ID: 6901951573 Enrollment ID: I20120726000493 |
| Provider Name | Jennifer Marion Snyder |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760737746 PECOS PAC ID: 1153578414 Enrollment ID: I20120822000231 |
| Provider Name | Mary Bartuccio Valentino |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326124991 PECOS PAC ID: 2668521519 Enrollment ID: I20130808000888 |
| Provider Name | Taylor N Keys |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275896334 PECOS PAC ID: 3173765534 Enrollment ID: I20130814000422 |
| Provider Name | Reena Lepine |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194004085 PECOS PAC ID: 4587835947 Enrollment ID: I20130830000704 |
| Provider Name | Michael Christensen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023239712 PECOS PAC ID: 9436307980 Enrollment ID: I20130830000756 |
| Provider Name | Rachel Grant |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154673705 PECOS PAC ID: 1153573050 Enrollment ID: I20131219001077 |
| Provider Name | Marie Irene Bodack |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356310353 PECOS PAC ID: 7113926395 Enrollment ID: I20140102000650 |
| Provider Name | Amanda Tompkins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053743534 PECOS PAC ID: 5193953669 Enrollment ID: I20140107000884 |
| Provider Name | Christopher Jean Borgman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861704454 PECOS PAC ID: 9931224383 Enrollment ID: I20140321000078 |
| Provider Name | Mary Hoang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043623937 PECOS PAC ID: 4688894645 Enrollment ID: I20140925002268 |
| Provider Name | Gregory Wolfe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114019296 PECOS PAC ID: 7113087446 Enrollment ID: I20150527001210 |
| Provider Name | Karen Squier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205941895 PECOS PAC ID: 8729083977 Enrollment ID: I20150618000452 |
| Provider Name | Kristina Haworth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124018510 PECOS PAC ID: 1456449149 Enrollment ID: I20151106001430 |
| Provider Name | Brian Knight |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992106942 PECOS PAC ID: 7315247277 Enrollment ID: I20151125000051 |
| Provider Name | Darah Mcdaniel-chandler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073965158 PECOS PAC ID: 5799078663 Enrollment ID: I20160729001668 |
| Provider Name | Jessica Ann Haynes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114301645 PECOS PAC ID: 9436430634 Enrollment ID: I20161230000918 |
| Provider Name | Shaleen Ragha |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013365642 PECOS PAC ID: 9931472925 Enrollment ID: I20170913004029 |
| Provider Name | Kristin L Adams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447779442 PECOS PAC ID: 7517232820 Enrollment ID: I20171011003091 |
| Provider Name | Barbara Jodoin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689024630 PECOS PAC ID: 0941576946 Enrollment ID: I20171018003159 |
| Provider Name | Tyler W Kitzman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164875787 PECOS PAC ID: 7416243563 Enrollment ID: I20171023001725 |
| Provider Name | Halie Cottrill |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437606316 PECOS PAC ID: 5193091726 Enrollment ID: I20171025002716 |
| Provider Name | Morgan Christopher Ollinger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467907832 PECOS PAC ID: 4082902093 Enrollment ID: I20171114002121 |
| Provider Name | Catherine Hogan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215459086 PECOS PAC ID: 7113279233 Enrollment ID: I20181017002414 |
| Provider Name | Daniel Russell Powell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841481405 PECOS PAC ID: 7810086782 Enrollment ID: I20181113003115 |
| Provider Name | Yueren Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184100935 PECOS PAC ID: 7113262890 Enrollment ID: I20181227002424 |
| Provider Name | April Marie Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295397016 PECOS PAC ID: 7517296882 Enrollment ID: I20190911002906 |
| Provider Name | Theresa Cassidy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124511266 PECOS PAC ID: 2860722543 Enrollment ID: I20190923002402 |
| Provider Name | Amy Farris Perkins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952684821 PECOS PAC ID: 5395068530 Enrollment ID: I20191002003331 |
| Provider Name | Thomas Cross Coleman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215070628 PECOS PAC ID: 5294167995 Enrollment ID: I20191119001076 |
| Provider Name | Stephanie Mcmillen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144882952 PECOS PAC ID: 7517399033 Enrollment ID: I20191120003327 |
| Provider Name | Laurel Roberts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396242533 PECOS PAC ID: 3779830898 Enrollment ID: I20191122002662 |
| Provider Name | Kevan Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578120796 PECOS PAC ID: 8628401528 Enrollment ID: I20191206002260 |
| Provider Name | Zachary German |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720640246 PECOS PAC ID: 6103256532 Enrollment ID: I20200424002763 |
| Provider Name | Kamil Annan Hill |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154974764 PECOS PAC ID: 5991135378 Enrollment ID: I20200427001440 |
| Provider Name | David Hall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740296888 PECOS PAC ID: 7416066717 Enrollment ID: I20200706001038 |
| Provider Name | Elyse Rayborn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346868197 PECOS PAC ID: 1557787835 Enrollment ID: I20200817003947 |
| Provider Name | Elizabeth B Pallante |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053920140 PECOS PAC ID: 1759707946 Enrollment ID: I20200818004228 |
| Provider Name | Brandee Nelson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639788961 PECOS PAC ID: 0244657146 Enrollment ID: I20200824001472 |
| Provider Name | Chawan Rasheed |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184249013 PECOS PAC ID: 0345667275 Enrollment ID: I20200824002613 |
| Provider Name | Patrick Thomas Fiddler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699388918 PECOS PAC ID: 0749608651 Enrollment ID: I20200909001628 |
| Provider Name | Deana Orvin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083055693 PECOS PAC ID: 8628298338 Enrollment ID: I20200911000468 |
| Provider Name | Torrie Marie Garner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760096788 PECOS PAC ID: 0042639023 Enrollment ID: I20200924000365 |
| Provider Name | Ryan Anderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164849964 PECOS PAC ID: 3971815390 Enrollment ID: I20201214001713 |
| Provider Name | Jacob Andrew Boehme |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942801907 PECOS PAC ID: 3375955412 Enrollment ID: I20201215001992 |
| Provider Name | Sarah Elizabeth Martine Maxey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629562905 PECOS PAC ID: 2466889423 Enrollment ID: I20210812000169 |
| Provider Name | Jacqueline Fiddler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013532480 PECOS PAC ID: 6103241757 Enrollment ID: I20210908000980 |
| Provider Name | Eliza A Seros |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184295982 PECOS PAC ID: 2567869373 Enrollment ID: I20210921003325 |
| Provider Name | Vassiliki Prattas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588334403 PECOS PAC ID: 5799182044 Enrollment ID: I20210929001114 |
| Provider Name | Lisa Wadolowski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164094702 PECOS PAC ID: 8729476718 Enrollment ID: I20211025000860 |
| Provider Name | Rimpi Nakhwal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801542493 PECOS PAC ID: 3779977988 Enrollment ID: I20220304001473 |
| Provider Name | Rachel Rintelmann Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285367482 PECOS PAC ID: 0042692105 Enrollment ID: I20220805001429 |
| Provider Name | Aaliyah Demi' Cole |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871221390 PECOS PAC ID: 2062896913 Enrollment ID: I20220826001944 |
| Provider Name | Marija Novakovich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689394884 PECOS PAC ID: 8123404357 Enrollment ID: I20220926002327 |
| Provider Name | Beth Katz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295407880 PECOS PAC ID: 2769868827 Enrollment ID: I20220928000269 |
| Provider Name | Mitchell W Kanellis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144930298 PECOS PAC ID: 9931578937 Enrollment ID: I20221214001687 |
| Provider Name | David A. Maze |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881796589 PECOS PAC ID: 0547255077 Enrollment ID: I20230412000243 |
| Provider Name | Tyler Roberts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346658945 PECOS PAC ID: 6406163906 Enrollment ID: I20230825002454 |
| Provider Name | Chelsea Piro Spalding |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790193399 PECOS PAC ID: 2264748466 Enrollment ID: I20230825002552 |
| Provider Name | Rachel Steele |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982337085 PECOS PAC ID: 7719340355 Enrollment ID: I20230829003240 |
| Provider Name | Jayci Jo Mccrory |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063190247 PECOS PAC ID: 2769831510 Enrollment ID: I20231206000323 |
| Provider Name | Shelby Nicole May-parmley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689285157 PECOS PAC ID: 2668890740 Enrollment ID: I20231206002268 |
| Provider Name | Katie Kwan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124672142 PECOS PAC ID: 4284042532 Enrollment ID: I20231211000643 |
| Provider Name | D'ajanee Smallwood |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073297164 PECOS PAC ID: 2466801626 Enrollment ID: I20231213001126 |
| Provider Name | Alexis Lambert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790463024 PECOS PAC ID: 6709235823 Enrollment ID: I20231213003978 |
| Provider Name | Abigail Klick |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174269377 PECOS PAC ID: 7416309216 Enrollment ID: I20240117002735 |
| Mailing Address | Practice Location Address |
|---|---|
| Southern College Of Optometry 1245 Madison Ave, Memphis, TN 38104-2211 Ph: (901) 722-3250 | Southern College Of Optometry 1225 Madison Ave, Memphis, TN 38104-2211 Ph: (901) 722-3250 |
Dr. Seth Aaron Salley, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 618 Oakleaf Office Ln Ste 100, Memphis, TN 38117 Phone: 901-821-8337 Fax: 901-379-8297 | |
Dr. Carrie Tobin Irvine, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1714 W Massey Rd, Memphis, TN 38120 Phone: 901-685-5520 Fax: 901-685-0782 | |
Shaleen Ragha, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1030 Jefferson Ave, Memphis, TN 38104 Phone: 901-523-8990 | |
Myeyedr. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 7825 Winchester Rd Ste 117, Memphis, TN 38125 Phone: 901-365-9732 Fax: 901-375-9005 | |
Dr. Azalia Rochelle Roach, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1245 Madison Ave, Memphis, TN 38104 Phone: 901-722-3200 | |
Dr. Daniel Gunn Fuller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1225 Madison Ave, Memphis, TN 38104 Phone: 901-722-3319 Fax: 901-722-3394 | |
Dr. Michael T Christensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1225 Madison Ave, Memphis, TN 38104 Phone: 901-722-3250 Fax: 901-722-3247 |