NPI age
18 years
Enumerated 2008-01-03
Across 807 active ophthalmology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 036127346 | ILLINOIS LICENSE |
| 01 (IN) | 01071747A | INDIANA LICENSE |
| 05 (IL) | 036127346 | |
| 01 (IL) | 036127346 | MEDICAL LICENSE |
| 05 (IN) | 201147260 | |
| 01 (IN) | 496710 | MEDICARE |
| 01 (IL) | 790730006 | MEDICARE PTAN |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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