Provider Demographics
NPI:1467550806
Name:CADE, CAROLINE LANETTE (OD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:LANETTE
Last Name:CADE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8480 US HIGHWAY 64
Mailing Address - Street 2:#101
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4187
Mailing Address - Country:US
Mailing Address - Phone:901-380-9010
Mailing Address - Fax:901-380-9019
Practice Address - Street 1:8480 HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133
Practice Address - Country:US
Practice Address - Phone:901-380-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1954152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU82689Medicare UPIN