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General NPI Number Information
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NPI Number | 1528944451
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Entity Type | Organization
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Legal Business Name | STAR OPTOMETRY GA LLC
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 5851 S VICKERY
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City | CUMMING
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State | GA
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Zip | 30040-8793
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Country | US
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Telephone | 678-648-5185
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 PARAGON RD STE 201
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City | DAYTON
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State | OH
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Zip | 45459-5323
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, REVENUE CYCLE MANAGEMENT
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Name | CHRISTA WILLIAMS
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Credential |
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Telephone | 904-312-2295
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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 |
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License Number State |
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