MEDICARE: EXCHANGE EYECARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1073474623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCHANGE EYECARE PC

Provider Business Mailing Address
First Line	:	271 3RD AVE BLDG 38200
Second Line	:
City	:	FORT GORDON
State	:	GA
Zip	:	30905-5904
Country	:	US
Telephone Number	:	706-771-9403
Fax Number	:	706-724-0239

Provider Business Practice Location Address
First Line	:	345 LINQUIST RD
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905-9998
Country	:	US
Telephone Number	:	706-771-9403
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL MICHAEL
Credential	:	OD
Telephone Number	:	706-951-6883

Provider Enumeration Date	:	11/22/2025
Last Update Date	:	03/02/2026

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Directions to “EXCHANGE EYECARE PC ” Practice Location

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