Provider Demographics
NPI:1942347356
Name:DESIGNER OPTICAL OF NASHVILLE EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DESIGNER OPTICAL OF NASHVILLE EYE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-834-8380
Mailing Address - Street 1:397 WALLACE RD
Mailing Address - Street 2:C-312
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4854
Mailing Address - Country:US
Mailing Address - Phone:615-834-8380
Mailing Address - Fax:615-834-5242
Practice Address - Street 1:397 WALLACE RD
Practice Address - Street 2:C-312
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4854
Practice Address - Country:US
Practice Address - Phone:615-834-8380
Practice Address - Fax:615-834-5242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1308920001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER