Provider Demographics
NPI:1467145730
Name:ROBERTSON, JOHN FLETCHER IV (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FLETCHER
Last Name:ROBERTSON
Suffix:IV
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1855 TANNER WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8332
Mailing Address - Country:US
Mailing Address - Phone:865-882-1535
Mailing Address - Fax:
Practice Address - Street 1:1855 TANNER WAY STE 120
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8331
Practice Address - Country:US
Practice Address - Phone:865-882-1535
Practice Address - Fax:865-882-9497
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN3828152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist