Provider Demographics
NPI:1043684293
Name:EYECARE PLUS MB PLLC
Entity Type:Organization
Organization Name:EYECARE PLUS MB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHEYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-988-5303
Mailing Address - Street 1:419 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2759
Mailing Address - Country:US
Mailing Address - Phone:615-601-3888
Mailing Address - Fax:
Practice Address - Street 1:419 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2759
Practice Address - Country:US
Practice Address - Phone:615-601-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty