Provider Demographics
NPI:1821540196
Name:SUMNER EYE CARE PLLC
Entity Type:Organization
Organization Name:SUMNER EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-452-2020
Mailing Address - Street 1:343 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3690
Mailing Address - Country:US
Mailing Address - Phone:615-452-2020
Mailing Address - Fax:615-452-2112
Practice Address - Street 1:343 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3690
Practice Address - Country:US
Practice Address - Phone:615-452-2020
Practice Address - Fax:615-452-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4334755Medicaid
TN103I418701Medicare PIN