Provider Demographics
NPI:1669120861
Name:COLUMBIA EYE PHYSICIANS PLLC
Entity type:Organization
Organization Name:COLUMBIA EYE PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-375-1050
Mailing Address - Street 1:1050 N JAMES M CAMPBELL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2754
Mailing Address - Country:US
Mailing Address - Phone:931-375-1050
Mailing Address - Fax:
Practice Address - Street 1:1050 N JAMES M CAMPBELL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2754
Practice Address - Country:US
Practice Address - Phone:931-375-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty