Organization

Dr Fred Davis And Associates

Optometrist in Lebanon, TN(View on Map)

Legal Business Name

Dr Fred Davis And Associates

NPI Number

1659604189

NPI Type

Organization

Enumeration Date

09/16/2009

Specialties

(Taxonomies)

Code

152W00000X

Primary Taxonomy

Yes

Licenses

State

Tennessee

License Number

1177

Contact
Information

Purpose

Mailing
Location

Address

615 S CUMBERLAND ST
615 S CUMBERLAND ST

City

Lebanon
Lebanon

State

TN
TN

Postal Code

37087-5107
37087-5107

Country

US
US

Telephone Number

(615) 449-9000
(615) 449-9000

Authorized Official

Name

Miss Jolene Hendrickson

Title or Position

OFFICE MANAGER

Telephone Number

(615) 449-9000

Identifiers

Identifier

35966341

Identifier State

TN

Identifier Issuer

MEDICARE PTAN

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

Data last updated by provider on 09/16/2009

Provider Address

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