Provider Demographics
NPI:1649498783
Name:TENNESSEE OPHTHALMOLOGY CONSULTANTS P.C.
Entity type:Organization
Organization Name:TENNESSEE OPHTHALMOLOGY CONSULTANTS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLYN
Authorized Official - Middle Name:LOUZELLE
Authorized Official - Last Name:CHERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-377-1255
Mailing Address - Street 1:3 MARYLAND FARMS
Mailing Address - Street 2:SUITE #120
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5005
Mailing Address - Country:US
Mailing Address - Phone:615-377-1255
Mailing Address - Fax:615-377-4989
Practice Address - Street 1:3 MARYLAND FARMS
Practice Address - Street 2:SUITE #120
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5005
Practice Address - Country:US
Practice Address - Phone:615-377-1255
Practice Address - Fax:615-377-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD26392174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3141724OtherBLUECROSS
TN3370667Medicaid
TN3370667Medicaid
TN3141724OtherBLUECROSS