NPI 1063601128 · live from the CMS NPI Registry
Patricia Anderson, O.D.
Optometrist in Kingsland, GA. National Provider Identifier 1063601128, active.
NPI record
| NPI | 1063601128 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 2003 Commerce Dr, Kingsland, GA 31548 |
| Practice phone | 912-882-3040 |
| Mailing address | 1950 Old Gallows Rd, Suite 520, Vienna, VA 22182 |
| Enumerated | October 15, 2007 |
| Last updated | September 27, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist, Low Vision Rehabilitation | 152WL0500X | WY222T (WY) |
| Optometrist primary | 152W00000X | OPT002807 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.