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General NPI Number Information
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NPI Number | 1205979242
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Entity Type | Individual
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Provider Name | WILLIAM ALLEN HERREN OD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 15 MILL CREEK CIRCLE
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City | POOLER
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State | GA
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Zip | 31322
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Country | US
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Telephone | 912-748-9646
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Fax | 912-748-9664
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Provider Business Mailing Address
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Address Line | 831 E 1ST ST
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City | MIDWAY
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State | GA
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Zip | 31320-7240
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Country | US
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Telephone | 912-884-5556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 881
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 881
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | 881
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License Number State | GA
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