Provider Demographics
NPI:1215070529
Name:LAWS, SUSAN J (OD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:LAWS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 DINAH SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-1424
Mailing Address - Country:US
Mailing Address - Phone:931-962-1266
Mailing Address - Fax:931-962-1221
Practice Address - Street 1:731 DINAH SHORE BLVD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1424
Practice Address - Country:US
Practice Address - Phone:931-962-1266
Practice Address - Fax:931-962-1221
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1699152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3029208OtherBCBST
TN410034849OtherRAILROAD MEDICARE
TN2240316OtherUNITED HEALTH CARE
TN3940457Medicaid
TN100026828OtherPHP TENNCARE
TNU61232Medicare UPIN
TN3940457Medicaid
TN2240316OtherUNITED HEALTH CARE