Radish, Gary Earle
Radish, Gary Earle is an individual health care provider with primary practice located at 2699 Townsend Ct , Clarksville TN 37043-6487. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Radish, Gary Earle can be contacted via phone (931) 647-8417.Contact Information
Primary practice address
2699 Townsend Ct
Clarksville TN 37043-6487
Phone: (931) 647-8417
Fax: (931) 648-4435
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD504 | Tennessee |
Profile Details
| NPI number | 1881666030 |
|---|---|
| LBN Legal business name | Radish, Gary Earle |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Feb 19th, 2015 - about 11 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 | 1881666030 | NPPES |
| Tennessee | MEDICAID | 3599833 | |
| Tennessee | MEDICAID | Q009062 |
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