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General NPI Number Information
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NPI Number | 1528009586
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Entity Type | Individual
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Provider Name | ROBERT WILLIAM EICHHAMMER O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 128 N PARK DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1645
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Country | US
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Telephone | 770-461-3060
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Fax | 770-460-9348
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Provider Business Mailing Address
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Address Line | 128 N PARK DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1645
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Country | US
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Telephone | 770-461-3060
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Fax | 770-460-9348
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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 | OPT000981
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License Number State | GA
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