NPI 1457404170 · live from the CMS NPI Registry
Brandy Carroll Augustine, O.D.
Optometrist in Marietta, GA. National Provider Identifier 1457404170, active.
NPI record
| NPI | 1457404170 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 895 Canton Rd Ne, #100, Marietta, GA 30060 |
| Practice phone | 770-427-8111 |
| Mailing address | 3427 River Heights Xing Se, Marietta, GA 30067 |
| Enumerated | January 18, 2007 |
| Last updated | December 6, 2011 |
| Sole proprietor | No |
| Other names | Brandy Carroll |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 2421 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.