Provider Demographics
NPI:1285860437
Name:BILLINGSLEY EYE CARE CORPORATION
Entity Type:Organization
Organization Name:BILLINGSLEY EYE CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BILLINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-681-3937
Mailing Address - Street 1:845 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-3595
Mailing Address - Country:US
Mailing Address - Phone:865-681-3937
Mailing Address - Fax:
Practice Address - Street 1:845 TURNER ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-3595
Practice Address - Country:US
Practice Address - Phone:865-681-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT 1436152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3599166Medicare PIN
TNU46749Medicare UPIN