Provider Demographics
NPI:1386227239
Name:ERICKSON, MALENA LANDON (OD)
Entity type:Individual
Prefix:DR
First Name:MALENA
Middle Name:LANDON
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 MANASSAS RD
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-6332
Mailing Address - Country:US
Mailing Address - Phone:615-719-3534
Mailing Address - Fax:
Practice Address - Street 1:600 E VETERANS DR
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4038
Practice Address - Country:US
Practice Address - Phone:931-372-1994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003678152W00000X
TN3941152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist