Sussmane, Shawn T
Sussmane, Shawn T is an sole proprietor health care provider with primary practice located at 1124 E Weisgarber Rd Ste 104 , Knoxville TN 37909-2686. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sussmane, Shawn T can be contacted via phone (865) 584-2127.Contact Information
Primary practice address
1124 E Weisgarber Rd Ste 104
Knoxville TN 37909-2686
Phone: (865) 584-2127
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TN2032 | Tennessee |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC6391 | Florida |
Profile Details
| NPI number | 1386644151 |
|---|---|
| LBN Legal business name | Sussmane, Shawn T |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | May 24th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386644151 | NPPES |
| Tennessee | Other | 4025051 | BCBS |
| Tennessee | MEDICAID | 3944150 | BCBS |
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