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3024 N Patterson St, Valdosta, GA 31602-1711 | |
(229) 247-4114 | |
(229) 245-9042 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 3024 N Patterson St, Valdosta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851406342 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Albert Gonzalez-acevedo |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1780681544 PECOS PAC ID: 8628974698 Enrollment ID: I20040715001185 |
Provider Name | Robert Gentile |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932194313 PECOS PAC ID: 0749203628 Enrollment ID: I20081111000206 |
Mailing Address | Practice Location Address |
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3024 N Patterson St, Valdosta, GA 31602-1711 Ph: (229) 247-4114 | 3024 N Patterson St, Valdosta, GA 31602-1711 Ph: (229) 247-4114 |