Provider Demographics
NPI:1568694529
Name:HO, JAMIE C (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:C
Last Name:HO
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 1:4639 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-4336
Mailing Address - Country:US
Mailing Address - Phone:857-413-0998
Mailing Address - Fax:
Practice Address - Street 1:5300 MARYLAND WAY
Practice Address - Street 2:SUITE 160
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5074
Practice Address - Country:US
Practice Address - Phone:615-604-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3083152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ007375Medicaid