Andrew W Howard, OD, PLLC
Organization Active NPI Optometrist · La Follette, TN
NPI 1851505366 · NPPES record last updated Mar 14, 2011
Key facts
- NPI
- 1851505366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- TN1769 (TN)
- Legal business name
- ANDREW W HOWARD, OD, PLLC
- Practice address
- 2145 Jacksboro Pike
La Follette, TN 37766-3003 - Phone
- (423) 562-1531
- Fax
- (423) 562-1724
- NPI assigned
- May 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Andrew Wade Howard, OD
- Title
- Chief Manager
- Phone
- (423) 562-1531
Practitioners 3
-
Monica Perry, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090128000194 | TN | Part B Supplier - Clinic/Group Practice | 3779647250 |
Receives reassigned benefits from 3 practitioners Practice locations: Jacksboro, TN |
National Provider Directory
Locations
2561 Jacksboro Pike
Jacksboro, TN 37757
Phone (423) 562-1531
2145 Jacksboro Pike
La Follette, TN 37766
Phone (423) 907-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | TN1769 | TN | Yes |
Addresses
Primary practice location
2145 Jacksboro Pike
La Follette, TN 37766-3003
Mailing address
2145 Jacksboro Pike
La Follette, TN 37766-3003
Phone (423) 562-1531
Other names
- LaFollette Eye Clinic
Other providers in La Follette, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.