Provider Demographics
NPI:1083012181
Name:OCULOPLASTIC SPECIALISTS OF TENNESSEE LLC
Entity Type:Organization
Organization Name:OCULOPLASTIC SPECIALISTS OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-297-5798
Mailing Address - Street 1:4306 HARDING PIKE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2205
Mailing Address - Country:US
Mailing Address - Phone:615-297-5798
Mailing Address - Fax:615-383-6646
Practice Address - Street 1:4306 HARDING PIKE
Practice Address - Street 2:SUITE 106
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2205
Practice Address - Country:US
Practice Address - Phone:615-297-5798
Practice Address - Fax:615-383-6646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN017927207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty