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General NPI Number Information
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NPI Number | 1427590314
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Entity Type | Individual
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Provider Name | ADRIANA ESCOBAR O.D
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Gender | Female
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 324 NEWNAN CROSSING BYP
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City | NEWNAN
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State | GA
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Zip | 30265-1082
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Country | US
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Telephone | 678-423-3927
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 SPRINGHURST BLVD SUITE NUMBER 103
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City | LOUISVILLE
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State | KY
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Zip | 40241-6137
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Country | US
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Telephone | 502-423-4444
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Fax | 502-423-4477
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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 | OPT002986
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License Number State | GA
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