Provider Demographics
NPI:1104858182
Name:TOOMEY, JEAN ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ANN
Last Name:TOOMEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1864
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-1864
Mailing Address - Country:US
Mailing Address - Phone:423-746-9988
Mailing Address - Fax:423-746-9984
Practice Address - Street 1:406 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-4232
Practice Address - Country:US
Practice Address - Phone:423-746-9988
Practice Address - Fax:423-746-9984
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNT1053152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6786897OtherCIGNA
TN3108368OtherBLUE CROSS BLUE SHIELD
TN3596845Medicaid
TN3108368OtherBLUE CROSS BLUE SHIELD
TN3596845Medicaid