NPI 1992872295 · live from the CMS NPI Registry
R Dale Anderson, OD
Optometrist in Morrow, GA. National Provider Identifier 1992872295, active.
NPI record
| NPI | 1992872295 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1544 Southlake Pkwy, Suite 9-B, Morrow, GA 30260 |
| Practice phone | 770-961-9090 |
| Mailing address | 310 Herring Ridge Ct, Grayson, GA 30017 |
| Enumerated | November 29, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 1153T (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.