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NPI Code Detail

MEDICARE: BARBARA KOLOZE O.D.

MEDICARE: BARBARA KOLOZE O.D.
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
1152W00000XOptometristOPT002634GA

General Provider Information

NPI Number : 1912225731
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA KOLOZE O.D.
Provider Business Mailing Address
First Line : 4280 E WEST CONNECTOR SE
Second Line : SMYRNA
City : SMYRNA
State : GA
Zip : 30082-4804
Country : US
Telephone Number : 770-435-4457
Fax Number : 770-435-4555
Provider Business Practice Location Address
First Line : 4280 E WEST CONNECTOR SE
Second Line : SMYRNA
City : SMYRNA
State : GA
Zip : 30082-4804
Country : US
Telephone Number : 770-435-4457
Fax Number : 770-435-4555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2010
Last Update Date : 05/02/2016

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Directions to “ BARBARA KOLOZE O.D.” Practice Location

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