Provider Demographics
NPI:1841518479
Name:LUMPKIN, ROSS B (OD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:B
Last Name:LUMPKIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 HIGHWAY 69A
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-6113
Mailing Address - Country:US
Mailing Address - Phone:731-599-2020
Mailing Address - Fax:
Practice Address - Street 1:2200 HIGHWAY 641 N
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-5276
Practice Address - Country:US
Practice Address - Phone:731-599-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2938152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist