Shepherd, Garrett Clark

Shepherd, Garrett Clark is an sole proprietor health care provider with primary practice located at 45 N Dixie Ave , Cookeville TN 38501-3372. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Shepherd, Garrett Clark can be contacted via phone (931) 526-2022.

Contact Information

Primary practice address
45 N Dixie Ave Cookeville TN 38501-3372
Phone: (931) 526-2022
Fax: (931) 528-1230
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD 0000002600 Tennessee

Profile Details

NPI number 1609827542
LBN Legal business name Shepherd, Garrett Clark
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2006
Last updated Sep 12th, 2013 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609827542 NPPES
Tennessee Other 4114922 BC/BS OF TN
Tennessee MEDICAID 3946671 BC/BS OF TN

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