Provider Demographics
NPI:1851679799
Name:FRAYSER EYE CLINIC
Entity Type:Organization
Organization Name:FRAYSER EYE CLINIC
Other - Org Name:FRAYSER EYE CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:PIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-496-4140
Mailing Address - Street 1:2307 W LAKE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-5784
Mailing Address - Country:US
Mailing Address - Phone:901-496-4140
Mailing Address - Fax:
Practice Address - Street 1:1750 FRAYSER BLVD STE E
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-6439
Practice Address - Country:US
Practice Address - Phone:901-496-4140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty