NPI age
14 years
Enumerated 2011-10-12
Across 2375 active optometrist providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (AL) | R256-TA-B08 | ALABAMA LICENSE NUMBER |
| 01 (GA) | 002997 | GEORGIA LICENSE NUMBER |
| 01 (MS) | 842 | MISSISSIPPI LICENSE NUMBER |
| 01 (FL) | 4662 | FLORIDA LICENSE NUMBER |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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