Provider Demographics
NPI:1972869667
Name:GARNSEY, JOSHUA MARTIN (OD)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:MARTIN
Last Name:GARNSEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 NEW SHACKLE ISLAND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2480
Mailing Address - Country:US
Mailing Address - Phone:615-447-3404
Mailing Address - Fax:615-431-0372
Practice Address - Street 1:264 NEW SHACKLE ISLAND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2480
Practice Address - Country:US
Practice Address - Phone:615-447-3404
Practice Address - Fax:615-431-0372
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN3022152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1527570Medicaid
TN103I411129OtherMEDICARE PTAN#