| |
620 Englewood Rd, Madisonville, TN 37354-1218 | |
(423) 442-2806 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 620 Englewood Rd, Madisonville, Tennessee |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720142771 | NPI | - | NPPES |
3590906 | Other | TN | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OD0000001689 (Tennessee) | Primary |
152W00000X | Optometrist | OD0000001899 (Tennessee) | Secondary |
152W00000X | Optometrist | OD0000001722 (Tennessee) | Secondary |
Mailing Address | Practice Location Address |
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Po Box 247, Madisonville, TN 37354-0247 Ph: (423) 442-2806 | 620 Englewood Rd, Madisonville, TN 37354-1218 Ph: (423) 442-2806 |
Dr. Tara K. Mullen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4525 Highway 411, Suite B, Madisonville, TN 37354 Phone: 423-442-8649 Fax: 423-420-3441 | |
Tara K. Mullen, O.d., P.c. Optometrist Medicare: Medicare Enrolled Practice Location: 4525 Highway 411, Suite B, Madisonville, TN 37354 Phone: 423-442-8649 Fax: 423-420-3441 |