Healthcare Provider Details

I. General information

NPI: 1700774122
Provider Name (Legal Business Name): VAISHNAVI T NARAIN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1781 CLAIRMONT RD
DECATUR GA
30033-4005
US

IV. Provider business mailing address

1781 CLAIRMONT RD
DECATUR GA
30033-4005
US

V. Phone/Fax

Practice location:
  • Phone: 404-471-9990
  • Fax: 404-471-9910
Mailing address:
  • Phone: 404-471-9990
  • Fax: 404-471-9910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003692
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: