Provider Demographics
NPI:1588744767
Name:CORNEA CONSULTANTS OF NASHVILLE, PLLC
Entity type:Organization
Organization Name:CORNEA CONSULTANTS OF NASHVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-320-7200
Mailing Address - Street 1:335 24TH AVE N STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1503
Mailing Address - Country:US
Mailing Address - Phone:615-320-7200
Mailing Address - Fax:615-320-7203
Practice Address - Street 1:335 24TH AVE N STE 600
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1503
Practice Address - Country:US
Practice Address - Phone:708-670-8173
Practice Address - Fax:615-320-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4098044OtherBCBS
TN3717165Medicare ID - Type UnspecifiedMEDICARE