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General NPI Number Information
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NPI Number | 1396274478
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Entity Type | Individual
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Provider Name | REBECCA GOAD OD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 101 NEWNAN ST
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City | CARROLLTON
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State | GA
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Zip | 30117-3225
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Country | US
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Telephone | 931-436-5382
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Fax |
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Provider Business Mailing Address
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Address Line | 119 MAPLE ST STE 205
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City | CARROLLTON
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State | GA
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Zip | 30117-3259
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Country | US
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Telephone | 931-436-5382
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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 | 3018
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License Number State | GA
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