Provider Demographics
NPI:1649232018
Name:RHYNE, MILES W JR (OD)
Entity Type:Individual
Prefix:
First Name:MILES
Middle Name:W
Last Name:RHYNE
Suffix:JR
Gender:M
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:PO BOX 32367
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2367
Mailing Address - Country:US
Mailing Address - Phone:865-437-3166
Mailing Address - Fax:865-851-9328
Practice Address - Street 1:9051 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4606
Practice Address - Country:US
Practice Address - Phone:865-437-3166
Practice Address - Fax:865-851-9328
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN0560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0708260001OtherMEDICARE, DMERC
TN0708260001OtherMEDICARE, DMERC
TNU25730Medicare UPIN