NPI 1366854150 · live from the CMS NPI Registry
Avalon Vision Center INC
Optometrist in Mcdonough, GA. National Provider Identifier 1366854150, active.
NPI record
| NPI | 1366854150 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1042 Avalon Parkway, Mcdonough, GA 30253 |
| Practice phone | 770-898-7078 |
| Mailing address | 950 Eagles Landing Pkwy, Suite 299, Stockbridge, GA 30281 |
| Enumerated | May 28, 2014 |
| Last updated | May 28, 2014 |
| Authorized official | Scot Werner, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | OPT001919 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.