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General NPI Number Information
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NPI Number | 1023365236
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Entity Type | Organization
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Legal Business Name | GOWDY VISION ASSOCIATES
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 807 RALPH DAVID ABERNATHY BLVD SW
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City | ATLANTA
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State | GA
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Zip | 30310-1807
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Country | US
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Telephone | 404-755-4300
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Fax | 404-755-8626
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Provider Business Mailing Address
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Address Line | 807 RALPH DAVID ABERNATHY BLVD SW
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City | ATLANTA
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State | GA
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Zip | 30310-1807
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Country | US
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Telephone | 404-755-4300
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Fax | 404-755-8626
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. SHEILA GOWDY
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Credential | OD
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Telephone | 678-429-2898
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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 | 1760
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License Number State | GA
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