Provider Demographics
NPI:1346251584
Name:PRESSON, ALAN SHANE (OD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:SHANE
Last Name:PRESSON
Suffix:
Gender:M
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:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1671152W00000X
VA0618000561152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504815Medicaid
TN35900352Medicare PIN
VAU62401Medicare UPIN