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General NPI Number Information
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NPI Number | 1023125572
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Entity Type | Organization
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Legal Business Name | PATRICIA HANKS OD PC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | FORT GORDON PXTRA, BLDG. 35200 OPTOMETRY CENTER
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City | FORT GORDON
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-771-9403
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Fax | 706-771-9167
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Provider Business Mailing Address
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Address Line | FORT GORDON PXTRA, BLDG. 35200 OPTOMETRY CENTER
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City | FORT GORDON
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-771-9403
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Fax | 706-771-9167
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. PATRICIA HANKS
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Credential | O.D.
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Telephone | 706-771-9403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT001250
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License Number State | GA
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