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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Portland, TN · Eyewear Supplier in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.