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General NPI Number Information
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NPI Number | 1386754836
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Entity Type | Individual
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Provider Name | MICHAEL S MCQUAIG O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 311 FLUKER ST
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City | THOMSON
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State | GA
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Zip | 30824-2108
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Country | US
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Telephone | 706-595-3502
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Fax | 706-597-8893
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Provider Business Mailing Address
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Address Line | 311 FLUKER ST P.O. BOX 660
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City | THOMSON
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State | GA
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Zip | 30824-2108
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Country | US
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Telephone | 706-595-3502
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Fax | 706-597-8893
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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 | 825T
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License Number State | GA
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