Provider Demographics
NPI:1891135166
Name:EAST TENNESSEE EYECARE ASSOCIATES, PC
Entity type:Organization
Organization Name:EAST TENNESSEE EYECARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:EICHENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-837-5404
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0039
Mailing Address - Country:US
Mailing Address - Phone:828-837-5404
Mailing Address - Fax:828-837-5621
Practice Address - Street 1:144 MEDICAL CENTER DR
Practice Address - Street 2:SUITE E
Practice Address - City:COPPERHILL
Practice Address - State:TN
Practice Address - Zip Code:37317-5005
Practice Address - Country:US
Practice Address - Phone:423-496-6336
Practice Address - Fax:423-496-6307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000049024207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty