Provider Demographics
NPI:1659679074
Name:EYE SURGERY CENTER OF MIDDLE TENNESSEE, LLC
Entity Type:Organization
Organization Name:EYE SURGERY CENTER OF MIDDLE TENNESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:LUNN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:615-620-9300
Mailing Address - Street 1:210 25TH AVE N
Mailing Address - Street 2:920
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1606
Mailing Address - Country:US
Mailing Address - Phone:615-620-9300
Mailing Address - Fax:615-620-9301
Practice Address - Street 1:210 25TH AVE N STE 920
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-9609
Practice Address - Country:US
Practice Address - Phone:615-964-5912
Practice Address - Fax:615-964-5913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000005261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical