| |
101 Park St, Ste A, Leesburg, GA 31763 | |
(229) 759-0028 | |
(229) 759-0058 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 101 Park St, Leesburg, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235359720 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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1119 E Lamar St, P O Box 788, Americus, GA 31709-3762 Ph: (229) 924-4022 | 101 Park St, Ste A, Leesburg, GA 31763 Ph: (229) 759-0028 |