Miraflores Eyecare, P.c. | |
6995 Concourse Pkwy, Douglasville, GA 30134-4551 | |
(770) 489-2622 | |
(770) 489-8318 |
Full Name | Miraflores Eyecare, P.c. |
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Type | Facility |
Speciality | Optometrist |
Location | 6995 Concourse Pkwy, Douglasville, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053472308 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2030 (Georgia) | Primary |
Provider Name | Kathleen A Miraflores |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932197712 PECOS PAC ID: 0345412136 Enrollment ID: I20111021000223 |
Mailing Address | Practice Location Address |
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Miraflores Eyecare, P.c. 2783 Bentley Pl Se, Marietta, GA 30067-5324 Ph: (770) 612-1372 | Miraflores Eyecare, P.c. 6995 Concourse Pkwy, Douglasville, GA 30134-4551 Ph: (770) 489-2622 |
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Mr. Edward Herman Pottlitzer, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2911 Chapel Hill Rd, Suite 210, Douglasville, GA 30135 Phone: 770-949-4223 Fax: 770-949-4994 |