NPI age
20 years
Enumerated 2005-10-06
Across 2375 active optometrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00004562B | |
| 01 (GA) | 0066145 | CIGNA |
| 01 (GA) | 202I417677 | MEDICARE PTAN |
| 01 (GA) | 24288 | BLUE CROSS BLUE SHEILD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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