NPI age
19 years
Enumerated 2006-10-03
Across 2375 active optometrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00366484C | |
| 01 (GA) | 410047413 | RR MEDICARE |
| 01 (GA) | 52401034003 | BCBS |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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