Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Maurise Gene Vandergriff Sr., LDO

Individual provider Optician · NPI 1427184019

Mr. Maurise Gene Vandergriff Sr., LDO is an Optician in Cleveland, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2007
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Practice location Address checks out

2415 Chambliss Ave NW
Cleveland, TN 37311-3882
Phone: (423) 479-4397
Fax: (423) 476-2974
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optician (primary) Taxonomy 156FX1800X · Licence DPO 319 (TN)

Record details

NPI number1427184019
Entity typeIndividual (Type 1)
GenderMale
Credentials LDO
Sole proprietorYes
NPI enumeratedFebruary 26, 2007
Last updated in NPPESMarch 6, 2008

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