NPI 1104907062 · live from the CMS NPI Registry
Carla D Anderson, O.D.
Optometrist in Atlanta, GA. National Provider Identifier 1104907062, active.
NPI record
| NPI | 1104907062 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 3730 Carmia Dr Sw, Ste 310, Atlanta, GA 30331 |
| Practice phone | 404-344-4136 |
| Mailing address | 3730 Carmia Dr Sw, Suite 310, Atlanta, GA 30331 |
| Enumerated | October 18, 2006 |
| Last updated | May 5, 2010 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | OPT002289 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.