Drew, Matthew Theodore

Drew, Matthew Theodore is an individual health care provider with primary practice located at 1111A Fort Campbell Blvd , Clarksville TN 37042-6426. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Drew, Matthew Theodore can be contacted via phone (931) 645-0346.

Contact Information

Primary practice address
1111A Fort Campbell Blvd Clarksville TN 37042-6426
Phone: (931) 645-0346
Fax: (931) 645-0348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2519 Tennessee

Profile Details

NPI number 1558387258
LBN Legal business name Drew, Matthew Theodore
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Apr 15th, 2019 - about 7 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 1558387258 NPPES
Kentucky MEDICAID 77001485

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