Provider Demographics
NPI:1164619094
Name:RAY N LABELLE
Entity Type:Organization
Organization Name:RAY N LABELLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:N
Authorized Official - Last Name:LABELLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-463-8440
Mailing Address - Street 1:106 INDIAN HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-6562
Mailing Address - Country:US
Mailing Address - Phone:865-463-8440
Mailing Address - Fax:865-463-9332
Practice Address - Street 1:106 INDIAN HILLS CIR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-6562
Practice Address - Country:US
Practice Address - Phone:865-463-8440
Practice Address - Fax:865-463-9332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1370152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNDR6983Medicare PIN
TN1164619094Medicare PIN
TN0299490001Medicare NSC