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General NPI Number Information
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NPI Number | 1376958843
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Entity Type | Organization
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Legal Business Name | STELLA ONYEKWELU, OD
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Dates
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Enumeration Date | 06/24/2014
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 502 BOOTH RD (INSIDE WALMART VISION CENTER)
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City | WARNER ROBINS
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State | GA
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Zip | 31088-3422
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Country | US
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Telephone | 478-918-0636
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Fax | 478-918-0683
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Provider Business Mailing Address
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Address Line | 86 WESTCLIFF CIR
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City | WARNER ROBINS
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State | GA
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Zip | 31093-8899
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DR
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Name | DR. STELLA ONYEKWELU
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Credential | OD
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Telephone | 618-741-3715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPT002814
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OPT002814
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002814
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License Number State | GA
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