Provider Demographics
NPI:1851324149
Name:ESTOPINAL, MARCEL RENE (MD)
Entity Type:Individual
Prefix:
First Name:MARCEL
Middle Name:RENE
Last Name:ESTOPINAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 WALLACE ROAD
Mailing Address - Street 2:C310
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-834-8310
Mailing Address - Fax:615-834-5242
Practice Address - Street 1:397 WALLACE ROAD
Practice Address - Street 2:C310 NASHVILLE EYE ASSOCIATES PC
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-834-8310
Practice Address - Fax:615-834-5242
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD023603207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3702958Medicaid
TN3067957Medicare ID - Type Unspecified
TN3702958Medicaid