Donald W Blocker DO

Organization Active NPI Eyewear Supplier · Portland, TN

NPI 1609078229 · NPPES record last updated Oct 24, 2014

Key facts

NPI
1609078229
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
Legal business name
DONALD W BLOCKER DO
Practice address
605 S Broadway
Portland, TN 37148-1619
Phone
(615) 325-2020
Fax
(615) 325-5862
NPI assigned
Jun 5, 2007
Reactivated
Mar 4, 2008
Organization subpart
Yes
Parent organization (as reported)
DONALD W BLOCKER OD

Authorized official

Name
Donald W Blocker, OD
Title
Owner Optometrist
Phone
(615) 325-2020

National Provider Directory

Part of
Portland Vision CL-Disp

Locations

605 S Broadway St
Portland, TN 37148
Phone (270) 651-2181

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Yes

Addresses

Primary practice location

605 S Broadway
Portland, TN 37148-1619

Mailing address

PO Box 470
Portland, TN 37148-0470
Phone (615) 325-2020

Other names

  • Portland Vision Clinic Doing business as

Other providers in Portland, TN

All providers in Portland, TN · Eyewear Supplier in Tennessee

Sources for this page

Verify at the official NPI Registry.