Provider Demographics
NPI:1225049380
Name:PRESSON, MICHELLE L (OD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:PRESSON
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 1:7660 OAK RIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931
Mailing Address - Country:US
Mailing Address - Phone:865-247-7715
Mailing Address - Fax:865-247-7716
Practice Address - Street 1:7660 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931
Practice Address - Country:US
Practice Address - Phone:865-247-7715
Practice Address - Fax:865-247-7716
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000555152W00000X
TN2704152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504813Medicaid
VA010070805Medicaid
TN1504813Medicaid
VA010070805Medicaid
TN35900462Medicare PIN