| |
6 Court Sq, Blakely, GA 39823-2637 | |
(229) 723-3644 | |
(229) 723-3054 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 6 Court Sq, Blakely, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922170117 | NPI | - | NPPES |
1770691693 | Other | GA | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 890 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
6 Court Sq, Blakely, GA 39823-2637 Ph: (229) 723-3644 | 6 Court Sq, Blakely, GA 39823-2637 Ph: (229) 723-3644 |