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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881666030 NPPES
Tennessee MEDICAID 3599833
Tennessee MEDICAID Q009062

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