Provider Demographics
NPI:1194405761
Name:PRECISION EYE CONSULTANTS
Entity type:Organization
Organization Name:PRECISION EYE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-294-5554
Mailing Address - Street 1:1815 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3130
Mailing Address - Country:US
Mailing Address - Phone:423-803-2020
Mailing Address - Fax:423-803-2021
Practice Address - Street 1:1815 GUNBARREL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3130
Practice Address - Country:US
Practice Address - Phone:334-294-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1346228426TMedicaid
TN1659938181Medicaid