Provider Demographics
NPI:1417037136
Name:THE EYE GROUP, P. C.
Entity Type:Organization
Organization Name:THE EYE GROUP, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:865-966-2020
Mailing Address - Street 1:11124 KINGSTON PIKE
Mailing Address - Street 2:SUITE 127
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934
Mailing Address - Country:US
Mailing Address - Phone:865-966-2020
Mailing Address - Fax:865-966-7332
Practice Address - Street 1:11124 KINGSTON PIKE
Practice Address - Street 2:SUITE 127
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934
Practice Address - Country:US
Practice Address - Phone:865-966-2020
Practice Address - Fax:865-966-7332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0873152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3598953Medicaid
TN3598953Medicare ID - Type Unspecified
TN3598953Medicaid