Provider Demographics
NPI:1841381118
Name:DELL, WARWICK C (OD)
Entity Type:Individual
Prefix:
First Name:WARWICK
Middle Name:C
Last Name:DELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8151 HIXSON PIKE
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-1801
Mailing Address - Country:US
Mailing Address - Phone:423-847-0498
Mailing Address - Fax:423-847-0499
Practice Address - Street 1:8151 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-1801
Practice Address - Country:US
Practice Address - Phone:423-847-0498
Practice Address - Fax:423-847-0499
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1519152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3098062OtherBLUECROSSBLUESHIELDNUMBER
TN4266950001OtherMEDICAREDEMPOS
TN3599512Medicare ID - Type Unspecified
TNU53107Medicare UPIN