Provider Demographics
NPI:1457161598
Name:SWEETWATER FAMILY EYECARE PLLC
Entity type:Organization
Organization Name:SWEETWATER FAMILY EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:423-519-8085
Mailing Address - Street 1:689A NEW HIGHWAY 68
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TN
Mailing Address - Zip Code:37874-1911
Mailing Address - Country:US
Mailing Address - Phone:423-519-8085
Mailing Address - Fax:
Practice Address - Street 1:689A NEW HIGHWAY 68
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874-1911
Practice Address - Country:US
Practice Address - Phone:423-337-9222
Practice Address - Fax:423-337-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty