Fayette Medical Clinic Optical Shop

NPI 1891910618 - Ophthalmology - 207W00000X

NPI Details
NPI 1891910618
Enumeration Date 04/16/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name RICK RICK
Position ADMINISTRATOR
Phone (770) 460-2331
Fax (770) 460-4016
Practice Location
101 YORKTOWN DR STE 225
FAYETTEVILLE GA, 30214-1568, US
Phone (770) 460-2331
Fax (770) 460-4016
Business Location
101 YORKTOWN DR STE 225
FAYETTEVILLE GA, 30214-1568, US
Phone (770) 460-2331
Fax (770) 460-4016
Toxanomy
Taxonomy Code 207W00000X
License State Georgia
License Number 20001558
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According to our database, Fayette Medical Clinic Optical Shop NPI is 1891910618, taxonomy code is 207W00000X and license number is 20001558, license state is located at Georgia. Fayette Medical Clinic Optical Shop physically located at 101 Yorktown Dr Ste 225, Fayetteville GA, 30214-1568. NPI Number 1033115704 has the healthcare provider type.

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1891910618 NPI number is provided on an as is basis without warranty of any kind. 1891910618 is maintained by the National Plan & Provider Enumeration System. The contents of Fayette Medical Clinic Optical Shop are for informational purposes only.