Healthcare Provider Details

I. General information

NPI: 1841593175
Provider Name (Legal Business Name): RUSSELL D SPRINGER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 HAWTHORNE AVE
ATHENS GA
30606-2881
US

IV. Provider business mailing address

270 HAWTHORNE AVE
ATHENS GA
30606-2881
US

V. Phone/Fax

Practice location:
  • Phone: 706-543-3599
  • Fax: 706-543-8681
Mailing address:
  • Phone: 706-543-3599
  • Fax: 706-543-8681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RUSSELL D. SPRINGER
Title or Position: OWNER
Credential: OD
Phone: 706-543-3599