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EYE M D OPHTHALMOLOGY PLLC NPI 1407984396


NPI Information

NPI: 1407984396
Provider Name: EYE M D OPHTHALMOLOGY PLLC

Former Legal Business Name: MAHAN - RIDLEY PLLC

Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
926 N JACKSON ST
TULLAHOMA, TN
ZIP 37388
Phone: (931) 393-6004
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EYE M D OPHTHALMOLOGY PLLC is an ophthalmology in Tullahoma, TN. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. EYE M D OPHTHALMOLOGY PLLC NPI is 1407984396. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Mahan - Ridley Pllc.

The provider's business location address is:

926 N JACKSON ST
TULLAHOMA, TN
ZIP 37388-300
Phone: (931) 393-6004
Fax: (931) 393-4795

The provider's authorized official is Ben Bob Mahan .
The authorized official title is Owner and has the following contact phone number (931) 393-6004.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 8/22/2017.


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
1152W00000XOptometristTN-OD-T394TENNESSEENo
2207W00000XOphthalmologyTN MD 9867TENNESSEENo
3207W00000XOphthalmologyTN MD18870TENNESSEEYes

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
13711455MEDICAIDTENNESSEE
23711455MEDICARE PINTENNESSEE

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: 5/5/2024

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