Provider Demographics
NPI:1659566784
Name:DINKINS, REBECCA JO (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JO
Last Name:DINKINS
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 1:5180 CASH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ENVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38332-1938
Mailing Address - Country:US
Mailing Address - Phone:731-608-5469
Mailing Address - Fax:
Practice Address - Street 1:547 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1703
Practice Address - Country:US
Practice Address - Phone:731-608-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR-200152W00000X
TN1944152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist