Provider Demographics
NPI:1023566809
Name:GREEN HILLS EYECARE
Entity Type:Organization
Organization Name:GREEN HILLS EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-297-7547
Mailing Address - Street 1:4301 HILLSBORO PIKE
Mailing Address - Street 2:STE 330
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3345
Mailing Address - Country:US
Mailing Address - Phone:615-297-7547
Mailing Address - Fax:
Practice Address - Street 1:4301 HILLSBORO PIKE
Practice Address - Street 2:STE 330
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3345
Practice Address - Country:US
Practice Address - Phone:615-297-7547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN2926152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty