Provider Demographics
NPI:1083832372
Name:UNION CITY EYE CARE, P.C.
Entity Type:Organization
Organization Name:UNION CITY EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BUGG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:731-885-1049
Mailing Address - Street 1:1022 S MILES AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5432
Mailing Address - Country:US
Mailing Address - Phone:731-885-1049
Mailing Address - Fax:731-885-6488
Practice Address - Street 1:1022 S MILES AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5432
Practice Address - Country:US
Practice Address - Phone:731-885-1049
Practice Address - Fax:731-885-6488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT867152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3732593Medicaid
TNT54684Medicare UPIN
TN5766360001Medicare NSC