NPI 1710002969 · live from the CMS NPI Registry
Ronald Becker, O.D.
Optometrist in Kennesaw, GA. National Provider Identifier 1710002969, active.
NPI record
| NPI | 1710002969 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1615 Ridenour Blvd Nw, 201, Kennesaw, GA 30152 |
| Practice phone | 770-499-2020 |
| Enumerated | March 20, 2007 |
| Last updated | August 29, 2013 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 661 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.