Healthcare Provider Details

I. General information

NPI: 1659298024
Provider Name (Legal Business Name): SHIRMARIE STARKS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CORPORATE CENTER DR STE 100
MORROW GA
30260-4128
US

IV. Provider business mailing address

1000 CORPORATE CENTER DR STE 100
MORROW GA
30260-4128
US

V. Phone/Fax

Practice location:
  • Phone: 770-968-8888
  • Fax:
Mailing address:
  • Phone: 770-968-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003776
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: