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General NPI Number Information
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NPI Number | 1497813877
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Entity Type | Individual
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Provider Name | PATRICIA HANKS O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FORT GORDON PXTRA, BLDG. 35200 OPTOMETRY CENTER
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City | FORT GORDON
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-771-9403
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Fax | 706-771-9167
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Provider Business Mailing Address
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Address Line | 54 RIVER BLUFF CT
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-6068
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Country | US
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Telephone | 803-279-6312
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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 | OPT001250
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License Number State | GA
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