Provider Demographics
NPI:1376793455
Name:MICHAEL R. POLITZER, O.D., CO
Entity Type:Organization
Organization Name:MICHAEL R. POLITZER, O.D., CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
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:615-604-2949
Mailing Address - Street 1:5300 MARYLAND WAY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5074
Mailing Address - Country:US
Mailing Address - Phone:615-604-2949
Mailing Address - Fax:615-376-0083
Practice Address - Street 1:5300 MARYLAND WAY
Practice Address - Street 2:SUITE 160
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5074
Practice Address - Country:US
Practice Address - Phone:615-604-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNT538OD152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty