Provider Demographics
NPI:1346528379
Name:DELL, JEREMIAH CHARLES (OD)
Entity Type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:CHARLES
Last Name:DELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:JEREMY
Other - Middle Name:CHARLES
Other - Last Name:DELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:6117 OOLTEWAH GEORGETOWN RD STE 109
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-5611
Mailing Address - Country:US
Mailing Address - Phone:232-383-2904
Mailing Address - Fax:423-238-3439
Practice Address - Street 1:6117 OOLTEWAH GEORGETOWN RD STE 109
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-5611
Practice Address - Country:US
Practice Address - Phone:232-383-2904
Practice Address - Fax:423-238-3439
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist