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General NPI Number Information
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NPI Number | 1073748810
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Entity Type | Organization
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Legal Business Name | GEORGE A DILLARD,O.D.,P.C.
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 710 N JEFFERSON ST
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City | ALBANY
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State | GA
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Zip | 31701-2361
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Country | US
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Telephone | 229-439-8821
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Fax | 229-439-2627
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Provider Business Mailing Address
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Address Line | 710 N JEFFERSON ST
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City | ALBANY
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State | GA
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Zip | 31701-2361
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Country | US
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Telephone | 229-439-8821
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Fax | 229-439-2627
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. GEORGE A DILLARD SR.
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Credential | O.D.
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Telephone | 229-439-8821
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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 |
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License Number State |
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