Provider Demographics
NPI:1841817426
Name:HAVILAND EYE CARE PLLC
Entity type:Organization
Organization Name:HAVILAND EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:NOELL
Authorized Official - Last Name:HAVILAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:731-415-7918
Mailing Address - Street 1:912 SHARPE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3439
Mailing Address - Country:US
Mailing Address - Phone:731-415-7918
Mailing Address - Fax:931-388-4254
Practice Address - Street 1:1301 TROTWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4702
Practice Address - Country:US
Practice Address - Phone:931-388-9041
Practice Address - Fax:931-388-4254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service