Provider Demographics
NPI:1326268178
Name:ASSOCIATED OPHTHALMIC SPECIALISTS, INC.
Entity Type:Organization
Organization Name:ASSOCIATED OPHTHALMIC SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-347-8495
Mailing Address - Street 1:7945 WOLF RIVER BLVD
Mailing Address - Street 2:STE 240
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1733
Mailing Address - Country:US
Mailing Address - Phone:901-347-8495
Mailing Address - Fax:901-347-8496
Practice Address - Street 1:7945 WOLF RIVER BLVD
Practice Address - Street 2:STE 240
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1733
Practice Address - Country:US
Practice Address - Phone:901-347-8495
Practice Address - Fax:901-347-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD5356174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty