Provider Demographics
NPI:1871656926
Name:FAMILY EYE CARE AND PEDIATRIC VISION CENTER, PLLC
Entity Type:Organization
Organization Name:FAMILY EYE CARE AND PEDIATRIC VISION CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER / PLLC MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CORBETT
Authorized Official - Last Name:HOLLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:423-247-3321
Mailing Address - Street 1:1203 N EASTMAN RD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-3145
Mailing Address - Country:US
Mailing Address - Phone:423-247-3321
Mailing Address - Fax:423-247-3631
Practice Address - Street 1:1203 N EASTMAN RD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-3145
Practice Address - Country:US
Practice Address - Phone:423-247-3321
Practice Address - Fax:423-247-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty