Provider Demographics
NPI:1558306043
Name:TURNER VISION OF TENNESSEE, PSC
Entity Type:Organization
Organization Name:TURNER VISION OF TENNESSEE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-637-7775
Mailing Address - Street 1:3051 KINZEL WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-2190
Mailing Address - Country:US
Mailing Address - Phone:865-637-7775
Mailing Address - Fax:865-524-6113
Practice Address - Street 1:3051 KINZEL WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-2190
Practice Address - Country:US
Practice Address - Phone:865-637-7775
Practice Address - Fax:865-524-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2310152W00000X, 152WC0802X, 152WP0200X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4079336OtherBLUE CROSS BLUE SHIELD
TN880251302OtherTRICARE
TN3731338Medicaid
TN3731338Medicare PIN
TN3731338Medicaid