NPI age
19 years
Enumerated 2007-01-12
Across 807 active ophthalmology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 000832785A | MD |
| 05 (GA) | 000188394D | |
| 05 (GA) | 000832785A | |
| 01 | 1316916646 | NPI |
| 01 | H00749 | UPIN |
| 01 | 18B0FPC | MC |
| 01 | 207W00000X | TAXONOMY CODE |
| 01 | 1497724447 | NPI |
| 01 (GA) | 047501 | LICENSE # |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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