Provider Demographics
NPI:1760839393
Name:AWORUNSE, FEYISAYO O (OD)
Entity Type:Individual
Prefix:
First Name:FEYISAYO
Middle Name:O
Last Name:AWORUNSE
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 1:1818 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2918
Mailing Address - Country:US
Mailing Address - Phone:615-341-4000
Mailing Address - Fax:
Practice Address - Street 1:1818 ALBION ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2918
Practice Address - Country:US
Practice Address - Phone:615-341-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALT224TAA39152W00000X
TNOD3307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist