National Provider Identifier Database

FAIRBANKS OCULAR PROSTHETICS INC
Ocularist


Contact Information

FAIRBANKS OCULAR PROSTHETICS, INC.
1720 WEST END AVE
SUITE 402
NASHVILLE, TN37203
Phone: 615-322-9940
Fax: 615-320-0970
Website:
Specialty Taxonomy Code
* Ocularist 156FX1700X

* Indicates primary specialty

NPI Profile & details for FAIRBANKS OCULAR PROSTHETICS, INC.

NPI Number 1700816949
Legal business name
LBN
FAIRBANKS OCULAR PROSTHETICS, INC.
Authorized official STEPHEN SANDERS - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/04/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: 05-311-11
  • KY Medicaid: 90262916
  • TN Medicaid: 1452191

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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