NPI age
19 years
Enumerated 2007-01-24
Across 2375 active optometrist providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 101698 | AVESIS RUN GA MEDICAID |
| 05 (GA) | 000872781A | |
| 01 | 08529 | SPECTERA INS ID |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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