NPI 1376539445 · live from the CMS NPI Registry
Renee Candace Ahlmark-Gordon, OD
Optometrist in Leesburg, GA. National Provider Identifier 1376539445, active.
NPI record
| NPI | 1376539445 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1569 Us Highway 19 S, Leesburg, GA 31763 |
| Practice phone | 229-439-1200 |
| Enumerated | September 23, 2005 |
| Last updated | March 29, 2023 |
| Sole proprietor | No |
| Other names | Renee Gordon |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | OPT002136 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.