Healthcare Provider Details

I. General information

NPI: 1255363024
Provider Name (Legal Business Name): PRCHAL AND PRCHAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 OLD DAWSON RD
ALBANY GA
31707-1513
US

IV. Provider business mailing address

2809 OLD DAWSON RD
ALBANY GA
31707-1513
US

V. Phone/Fax

Practice location:
  • Phone: 229-888-3937
  • Fax: 229-888-6369
Mailing address:
  • Phone: 229-888-3937
  • Fax: 229-888-6369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1268
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2305
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number890T
License Number StateGA

VIII. Authorized Official

Name: DR. GERALD J PRCHAL
Title or Position: CEO/OWNER
Credential: O.D.
Phone: 229-888-3937