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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568461564 NPPES
Other 602004601 CARITEN
Other 620927830 CARITEN
Other 2005369 CARITEN
Other 620927830 CARITEN

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