KINGSPORT TN OPHTHALMOLOGY ASC LLC NPI 1649244211

NPI Information

NPI: 1649244211
Provider Name: KINGSPORT TN OPHTHALMOLOGY ASC LLC

Doing Business As: THE REGIONAL EYE SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
999 EXECUTIVE PARK BLVD
SUITE 100
KINGSPORT, TN
ZIP 37660
Phone: (423) 247-2022
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KINGSPORT TN OPHTHALMOLOGY ASC LLC is an ambulatory surgical clinic center in Kingsport, TN. KINGSPORT TN OPHTHALMOLOGY ASC LLC NPI is 1649244211. The provider is registered as an organization entity type.
The provider Is Doing Business As The Regional Eye Surgery Center.

The provider's business location address is:

999 EXECUTIVE PARK BLVD
SUITE 100
KINGSPORT, TN
ZIP 37660-632
Phone: (423) 247-2022
Fax: (423) 247-2027

The provider's authorized official is Phillip Clendenin .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The enumeration date for this NPI number is 2/13/2006 and was last updated on 8/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	0000000158	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00057294	OTHER	TENNESSEE	MEDICARE RAILROAD
2	=========	OTHER	TENNESSEE	TRICARE
3	3288818	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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