| |
775 C Kingsbay Road, St Marys, GA 31558 | |
(912) 729-6111 | |
(912) 729-8595 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 775 C Kingsbay Road, St Marys, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346390895 | NPI | - | NPPES |
000954291A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT0001798 (Georgia) | Primary |
Mailing Address | Practice Location Address |
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775 C Kingsbay Road, St Marys, GA 31558 Ph: (912) 729-6111 | 775 C Kingsbay Road, St Marys, GA 31558 Ph: (912) 729-6111 |