Provider Demographics
NPI:1184996605
Name:THE EYE CARE CLINIC
Entity type:Organization
Organization Name:THE EYE CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-694-7527
Mailing Address - Street 1:7600 KINGSTON PIKE
Mailing Address - Street 2:SUITE 1480
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5600
Mailing Address - Country:US
Mailing Address - Phone:865-694-7527
Mailing Address - Fax:865-694-0021
Practice Address - Street 1:7600 KINGSTON PIKE
Practice Address - Street 2:SUITE 1480
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5600
Practice Address - Country:US
Practice Address - Phone:865-694-7527
Practice Address - Fax:865-694-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN736152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I412609Medicare UPIN