Mahan - Ridley Pllc

LBN: Eye M D Ophthalmology Pllc
Mahan - Ridley Pllc is an health care organization with primary practice located at 926 N Jackson St , Tullahoma TN 37388-2300. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty. Eye M D Ophthalmology Pllc can be contacted via phone (931) 393-6004, or through Mahan, Ben Bob via phone (931) 393-6004.

Contact Information

Primary practice address
926 N Jackson St Tullahoma TN 37388-2300
Phone: (931) 393-6004
Fax: (931) 393-4795
Website:
Map and Directions
Authorized official contact:
Name: Mahan, Ben Bob Doctor of Medicine (MD)
Phone: (931) 393-6004

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TN-OD-T394 Tennessee
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X TN MD18870 Tennessee
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X TN MD 9867 Tennessee

Profile Details

NPI number 1407984396
LBN Legal business name Eye M D Ophthalmology Pllc
DBA Doing business as Mahan - Ridley Pllc
Authorized official Mahan, Ben Bob Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2007
Last updated Aug 22nd, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407984396 NPPES
Tennessee MEDICAID 3711455

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