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General NPI Number Information
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NPI Number | 1336510767
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Entity Type | Organization
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Legal Business Name | BUFORD OPTICS LLC
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 3264 BUFORD DR 100-A
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City | BUFORD
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State | GA
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Zip | 30519-8764
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Country | US
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Telephone | 404-730-2365
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Fax |
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Provider Business Mailing Address
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Address Line | 3264 BUFORD DR 100-A
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City | BUFORD
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State | GA
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Zip | 30519-8764
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Country | US
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Telephone | 678-730-2365
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTROR
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Name | FAREED DOSANI
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Credential | O.D.
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Telephone | 770-655-0989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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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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