Provider Demographics
NPI:1609868363
Name:CAMDEN EYE CARE ASSOCIATES
Entity Type:Organization
Organization Name:CAMDEN EYE CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REYNOLDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:731-584-7942
Mailing Address - Street 1:264 HIGHWAY 641 N
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-1329
Mailing Address - Country:US
Mailing Address - Phone:731-584-7942
Mailing Address - Fax:731-584-7965
Practice Address - Street 1:264 HIGHWAY 641 N
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-1329
Practice Address - Country:US
Practice Address - Phone:731-584-7942
Practice Address - Fax:731-584-7965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000002255152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN50537OtherDAVIS VISION
TN7536377OtherAETNA
TN11494632OtherUNITED HEALTHCARE
TN3945315Medicaid
TN1012691-0556551OtherBLOCKVISION
TN4076769OtherTENNCARE SELECT
TN50537OtherBETTERHEALTH
TN4076769OtherBLUE CROSS BLUE SHIELD
TNP00193746-DC310OtherRAILROAD MEDICARE
TNP00193746-DC310OtherRAILROAD MEDICARE
TN1012691-0556551OtherBLOCKVISION
TN7536377OtherAETNA
TNU91213Medicare UPIN