Provider Demographics
NPI:1295760072
Name:GIVENS COLEY, GINGER L (OD)
Entity type:Individual
Prefix:DR
First Name:GINGER
Middle Name:L
Last Name:GIVENS COLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:GINGER
Other - Middle Name:LEA
Other - Last Name:GIVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:129 E CLARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2112
Mailing Address - Country:US
Mailing Address - Phone:615-893-8847
Mailing Address - Fax:615-896-3677
Practice Address - Street 1:129 E CLARK BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2112
Practice Address - Country:US
Practice Address - Phone:615-893-8847
Practice Address - Fax:615-896-3677
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1101152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4052027OtherBC/BS GROUP
TN12641OtherHEALTHNET BLOCK
TN2240262OtherUNITED HEALTH CARE
TN3040208OtherBC/BS
TN0448280001OtherDMERC
TN3052066OtherTN CARE SELECT
TN5653005OtherCIGNA
MI7102000TN37130OtherBC/BS OF MICHIGAN
TN9366061OtherPHCS
TN3598283Medicaid
TN62-1380849OtherGROUP TAX ID
MI7102000TN37130OtherBC/BS OF MICHIGAN
TN12641OtherHEALTHNET BLOCK
TNU12561Medicare UPIN