Provider Demographics
NPI:1669483673
Name:UNIVERSITY EYE SPECIALISTS, PC
Entity Type:Organization
Organization Name:UNIVERSITY EYE SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-244-1989
Mailing Address - Street 1:1928 ALCOA HWY STE 324
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1505
Mailing Address - Country:US
Mailing Address - Phone:865-524-9871
Mailing Address - Fax:
Practice Address - Street 1:500 MCFARLAND ST STE A
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3992
Practice Address - Country:US
Practice Address - Phone:423-581-2760
Practice Address - Fax:423-586-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0727320002OtherDMERC - MTN
0727320002OtherDMERC - MTN