Drew, Matthew Theodore
Drew, Matthew Theodore is an individual health care provider with primary practice located at 1111A Fort Campbell Blvd , Clarksville TN 37042-6426. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Drew, Matthew Theodore can be contacted via phone (931) 645-0346.Contact Information
Primary practice address
1111A Fort Campbell Blvd
Clarksville TN 37042-6426
Phone: (931) 645-0346
Fax: (931) 645-0348
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2519 | Tennessee |
Profile Details
| NPI number | 1558387258 |
|---|---|
| LBN Legal business name | Drew, Matthew Theodore |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Apr 15th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558387258 | NPPES |
| Kentucky | MEDICAID | 77001485 |
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