Provider Demographics
NPI:1902097058
Name:JOEL G. ORTON
Entity Type:Organization
Organization Name:JOEL G. ORTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:ORTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:931-363-6147
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-0595
Mailing Address - Country:US
Mailing Address - Phone:931-363-6147
Mailing Address - Fax:931-363-6155
Practice Address - Street 1:1000 EAST COLLEGE STREET
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4517
Practice Address - Country:US
Practice Address - Phone:931-363-6147
Practice Address - Fax:931-363-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN540T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCK2477OtherMEDICARE RAILROAD
TN3943803Medicaid
TN0708480001Medicare NSC
TNCK2477OtherMEDICARE RAILROAD
TNT61128Medicare UPIN