Pedersen, William R
Pedersen, William R is an sole proprietor health care provider with primary practice located at 730 W Lamar Alexander Pkwy , Maryville TN 37801-3900. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Pedersen, William R can be contacted via phone (865) 982-2020.Contact Information
Primary practice address
730 W Lamar Alexander Pkwy
Maryville TN 37801-3900
Phone: (865) 982-2020
Fax: (865) 970-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD0000000552 | Tennessee |
Profile Details
| NPI number | 1568461564 |
|---|---|
| LBN Legal business name | Pedersen, William R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Sep 15th, 2014 - about 12 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 | 1568461564 | NPPES |
| Other | 602004601 | CARITEN | |
| Other | 620927830 | CARITEN | |
| Other | 2005369 | CARITEN | |
| Other | 620927830 | CARITEN |
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