MEDICARE: MYEYEDR OPTOMETRY OF GEORGIA, LLC

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	OPT002656	GA

General Provider Information

NPI Number	:	1760883904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYEYEDR OPTOMETRY OF GEORGIA, LLC

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:	571-223-6780

Provider Business Practice Location Address
First Line	:	105 GRAND CENTRAL BLVD
Second Line	:	SUITE #110
City	:	POOLER
State	:	GA
Zip	:	31322-4148
Country	:	US
Telephone Number	:	912-450-9200
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	SUE DOWNES
Credential	:
Telephone Number	:	703-847-8899

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	05/26/2022

Similar Medicare Providers

1922720846 — MRS. SYDNIE LEEANN FORDHAM BCBA
Practice Location Address:

105 GRAND CENTRAL BLVD
POOLER, GA
31322-4148

Practice Phone: 912-244-3305
Practice Fax:

1710047329 — DR. ROBIN G BERDING O.D
Practice Location Address:

105 GRAND CENTRAL BLVD STE 110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax: 912-450-9201

1336463744 — SALEM COUNSELING AND CONSULTING, LLC
Practice Location Address:

105 GRAND CENTRAL BLVD , SUITE 107
POOLER, GA
31322-4148

Practice Phone: 912-308-8318
Practice Fax: 912-748-3847

1497001382 — DR. LEEWOOD BRAWNER STILL O.D.
Practice Location Address:

105 GRAND CENTRAL BLVD , SUITE 110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax:

1497098875 — MR. DANIEL LUIS ORSINI SFIDC
Practice Location Address:

105 GRAND CENTRAL BLVD STE 108
POOLER, GA
31322-4148

Practice Phone: 912-748-1515
Practice Fax:

1215375480 — DR. BENJAMIN JOHNSON CRIDER O.D.
Practice Location Address:

105 GRAND CENTRAL BLVD STE 110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax: 912-450-9201

Directions to “MYEYEDR OPTOMETRY OF GEORGIA, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.