Provider Demographics
NPI:1518118348
Name:NORTH PARK OPTICAL CENTER
Entity Type:Organization
Organization Name:NORTH PARK OPTICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHRLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-870-8000
Mailing Address - Street 1:5022 OLD GODSEY LN
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-6600
Mailing Address - Country:US
Mailing Address - Phone:423-870-8000
Mailing Address - Fax:423-870-4044
Practice Address - Street 1:5022 OLD GODSEY LN
Practice Address - Street 2:SUITE 7
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-6600
Practice Address - Country:US
Practice Address - Phone:423-870-8000
Practice Address - Fax:423-870-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier