| |
5 S Mcintosh St, Elberton, GA 30635-2465 | |
(706) 283-7510 | |
(706) 283-7570 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 5 S Mcintosh St, Elberton, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649681768 | NPI | - | NPPES |
000791568J | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT002405 (Georgia) | Secondary |
152W00000X | Optometrist | OPT002596 (Georgia) | Secondary |
207W00000X | Ophthalmology | 045447 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
5 South Mcintosh Street, Elberton, GA 30635 Ph: (706) 546-9290 | 5 S Mcintosh St, Elberton, GA 30635-2465 Ph: (706) 283-7510 |