Provider Demographics
NPI:1982691812
Name:BYNUM, FRANCES DICKSON (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:DICKSON
Last Name:BYNUM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HIGHWAY 431
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-8264
Mailing Address - Country:US
Mailing Address - Phone:731-587-2022
Mailing Address - Fax:731-587-9397
Practice Address - Street 1:105 HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-8264
Practice Address - Country:US
Practice Address - Phone:731-587-2022
Practice Address - Fax:731-587-9397
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1767152W00000X
FLOP0002996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3153049OtherBCBS
TN3590029OtherNEW MEDICARE PTAN
TN4030100001OtherPALMETTO
TN410033713OtherRAILROAD MEDICARE
TN6416OtherTLC
TNU62712Medicare UPIN
TN3940650Medicare ID - Type Unspecified