Healthcare Provider Details

I. General information

NPI: 1477557957
Provider Name (Legal Business Name): LOUIS M SCHLESINGER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 CORDER RD
WARNER ROBINS GA
31088-3604
US

IV. Provider business mailing address

216 CORDER RD
WARNER ROBINS GA
31088-3604
US

V. Phone/Fax

Practice location:
  • Phone: 478-923-5872
  • Fax: 478-922-9020
Mailing address:
  • Phone: 478-923-5872
  • Fax: 478-922-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number001117
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: