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General NPI Number Information
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NPI Number | 1508047408
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Entity Type | Organization
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Legal Business Name | MICHAEL J GARNER OD PC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1830 HWY 82 W
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City | TIFTON
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State | GA
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Zip | 31793-8164
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Country | US
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Telephone | 229-387-8863
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 72444
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City | ALBANY
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State | GA
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Zip | 31708-2444
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Country | US
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Telephone | 229-387-8863
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MICHAEL J GARNER
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Credential | OD
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Telephone | 229-387-8863
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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 | 816
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License Number State | GA
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