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: 07/06/2026
Certification Date: 06/09/2026
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
- Phone: 770-968-8888
- Fax:
- Phone: 770-968-8888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: