Provider Demographics
NPI:1558488262
Name:EYE CARE CENTERS PLLC
Entity Type:Organization
Organization Name:EYE CARE CENTERS PLLC
Other - Org Name:KINGSTON EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OFFIER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-882-7470
Mailing Address - Street 1:2497 S ROANE ST
Mailing Address - Street 2:STE 110
Mailing Address - City:ROCKWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37854
Mailing Address - Country:US
Mailing Address - Phone:865-882-7470
Mailing Address - Fax:865-882-8933
Practice Address - Street 1:509 N KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2630
Practice Address - Country:US
Practice Address - Phone:865-376-7474
Practice Address - Fax:865-376-7476
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE CARE CENTERS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-26
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN833ODT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty