Provider Demographics
NPI:1831452861
Name:DR. JEFFREY A. ROTHMAN AND ASSOC, PC
Entity type:Organization
Organization Name:DR. JEFFREY A. ROTHMAN AND ASSOC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-859-8880
Mailing Address - Street 1:910 RIVERGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2323
Mailing Address - Country:US
Mailing Address - Phone:615-859-8880
Mailing Address - Fax:615-859-6829
Practice Address - Street 1:910 RIVERGATE PKWY
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2323
Practice Address - Country:US
Practice Address - Phone:615-859-8880
Practice Address - Fax:615-859-6829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD747152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty