Provider Demographics
NPI:1346752474
Name:POLITZER CONSULTING GROUP LLC
Entity Type:Organization
Organization Name:POLITZER CONSULTING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF BOARD
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:POLITZER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-330-3895
Mailing Address - Street 1:144 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7170
Mailing Address - Country:US
Mailing Address - Phone:615-330-3895
Mailing Address - Fax:
Practice Address - Street 1:144 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-7170
Practice Address - Country:US
Practice Address - Phone:615-330-3895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000000538152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3593303Medicaid