| Lighthouse Optical Of Tennessee, Llc | |
|
430 Neal St, Cookeville, TN 38501-0916 | |
| (931) 528-6411 | |
| (931) 372-0380 |
| Full Name | Lighthouse Optical Of Tennessee, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 430 Neal St, Cookeville, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609066703 | NPI | - | NPPES |
| 3087067 | Other | TN | BLUE CROSS BLUE SHIELD TN |
| 3945214 | Other | TN | GROUP PROVIDER NUMBER |
| 3596618 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OD T-1155 (Tennessee) | Primary |
| Provider Name | Amanda J Kirk |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477860708 PECOS PAC ID: 6103094966 Enrollment ID: I20110721000450 |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Optical Of Tennessee, Llc 430 Neal St, Cookeville, TN 38501-0916 Ph: (931) 528-6411 | Lighthouse Optical Of Tennessee, Llc 430 Neal St, Cookeville, TN 38501-0916 Ph: (931) 528-6411 |
Eye Centers Of Tennessee, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 999 Guardian Way, Cookeville, TN 38501 Phone: 931-650-4100 Fax: 931-650-4101 | |
Dr. Deanna Apple Risher, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 585 E 10th St, Cookeville, TN 38501 Phone: 931-526-6711 | |
Dr. James E. Miller, OPTM Optometrist Medicare: May Accept Medicare Assignments Practice Location: 628 E 10th St, Cookeville, TN 38501 Phone: 931-526-2143 Fax: 931-526-5217 | |
Matthew Kurt Mosteller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 768 S Jefferson Ave, Cookeville, TN 38501 Phone: 931-646-5900 Fax: 931-646-5901 | |
Dr. Rachel Marie Wakefield, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 585 E 10th St, Cookeville, TN 38501 Phone: 931-526-6711 Fax: 931-526-6712 | |
Mullins Vision Associates,pllc Optometrist Medicare: Medicare Enrolled Practice Location: 585 E 10th St, Cookeville, TN 38501 Phone: 931-526-6711 Fax: 931-526-6712 | |
Ronald Miranda, OD Optometrist Medicare: Medicare Enrolled Practice Location: 377 W Jackson St, Cookeville, TN 38501 Phone: 931-525-1268 Fax: 931-520-8717 |