Provider Demographics
NPI:1891050050
Name:EYE CARE ASSOCIATES OF SPARTA
Entity Type:Organization
Organization Name:EYE CARE ASSOCIATES OF SPARTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:PAROD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:931-836-6433
Mailing Address - Street 1:455 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-1360
Mailing Address - Country:US
Mailing Address - Phone:931-836-6433
Mailing Address - Fax:931-836-2753
Practice Address - Street 1:455 VISTA DR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1360
Practice Address - Country:US
Practice Address - Phone:931-836-6433
Practice Address - Fax:931-836-2753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty