Healthcare Provider Details

I. General information

NPI: 1588822886
Provider Name (Legal Business Name): FRANCES D. MCMULLAN, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 MOUNT VERNON RD
DUNWOODY GA
30338-4224
US

IV. Provider business mailing address

2538 PARKSIDE DR NE
ATLANTA GA
30305-3732
US

V. Phone/Fax

Practice location:
  • Phone: 770-393-0003
  • Fax:
Mailing address:
  • Phone: 404-797-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number021751
License Number StateGA

VIII. Authorized Official

Name: DR. FRANCES D MCMULLAN
Title or Position: OWENER
Credential: M.D.
Phone: 404-797-2020