NPI 1790346476 · live from the CMS NPI Registry
2020atlanta PC
Optometrist in Atlanta, GA. National Provider Identifier 1790346476, active.
NPI record
| NPI | 1790346476 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 20 10th St Nw Unit 1101, Atlanta, GA 30309 |
| Practice phone | 617-356-9117 |
| Enumerated | June 24, 2019 |
| Last updated | June 24, 2019 |
| Authorized official | David Gibson, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.