Male or Other

Dr. Theo H. Ezell O.D.

Optometrist in Goodlettsville, TN(View on Map)

Full Name

Dr. Theo Howard Ezell O.D.

NPI Number

1033386230

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/15/2008

Specialties

(Taxonomies)

Code

152W00000X

Primary Taxonomy

Yes

Licenses

State

Tennessee

License Number

OD 493

Contact
Information

Purpose

Mailing
Location

Address

525 RIVERGATE PKWY
525 RIVERGATE PKWY

City

Goodlettsville
Goodlettsville

State

TN
TN

Postal Code

37072-2078
37072-2078

Country

US
US

Telephone Number

(615) 859-1928
(615) 859-1928

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/15/2008

Provider Address

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