Provider Demographics
NPI:1184199515
Name:NEWPORT FAMILY EYECARE
Entity Type:Organization
Organization Name:NEWPORT FAMILY EYECARE
Other - Org Name:TARR FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:BLANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:TARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-242-7548
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37822-0761
Mailing Address - Country:US
Mailing Address - Phone:865-242-7548
Mailing Address - Fax:
Practice Address - Street 1:1002 W HIGHWAY 25/70
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821
Practice Address - Country:US
Practice Address - Phone:423-720-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty