Provider Demographics
NPI:1952616567
Name:MARGARET E DAVIS
Entity Type:Organization
Organization Name:MARGARET E DAVIS
Other - Org Name:DR. LISA DAVIS VISIONCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-823-2482
Mailing Address - Street 1:4811 TROUSDALE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1333
Mailing Address - Country:US
Mailing Address - Phone:615-823-2482
Mailing Address - Fax:
Practice Address - Street 1:4811 TROUSDALE DR
Practice Address - Street 2:SUITE A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1333
Practice Address - Country:US
Practice Address - Phone:615-823-2482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1478152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510944Medicaid
TN1510944Medicaid