Provider Demographics
NPI:1770648016
Name:UNIVERSITY EYE SURGEONS, P.C.
Entity Type:Organization
Organization Name:UNIVERSITY EYE SURGEONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-524-9871
Mailing Address - Street 1:1928 ALCOA HWY
Mailing Address - Street 2:SUITE 324
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1502
Mailing Address - Country:US
Mailing Address - Phone:865-524-9871
Mailing Address - Fax:865-305-6695
Practice Address - Street 1:500 MCFARLAND ST
Practice Address - Street 2:SUITE A
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:2006-12-27
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3379080Medicare PIN