Provider Demographics
NPI:1942292438
Name:JOSLIN, BRYCE HICKMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:HICKMAN
Last Name:JOSLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PEACOCK CT
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865
Mailing Address - Country:US
Mailing Address - Phone:865-577-2002
Mailing Address - Fax:865-577-2046
Practice Address - Street 1:125 PEACOCK CT
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865
Practice Address - Country:US
Practice Address - Phone:865-577-2002
Practice Address - Fax:865-577-2046
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1924152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1214850001Medicare NSC
TN3942730Medicare PIN
TNU75627Medicare UPIN