Provider Demographics
NPI:1962683573
Name:EYEXCEL, PLLC
Entity Type:Organization
Organization Name:EYEXCEL, PLLC
Other - Org Name:EYEXCEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-687-1232
Mailing Address - Street 1:PO BOX 12218
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912
Mailing Address - Country:US
Mailing Address - Phone:865-687-1232
Mailing Address - Fax:865-687-8256
Practice Address - Street 1:715 CALLAHAN DR.
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912
Practice Address - Country:US
Practice Address - Phone:865-687-1232
Practice Address - Fax:865-687-8256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0708260001Medicare NSC