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General NPI Number Information
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NPI Number | 1558542662
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Entity Type | Individual
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Provider Name | SHAVON CHEREASE BILLINGSLEY O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1114 NORTHPOINT CIR
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City | ALPHARETTA
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State | GA
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Zip | 30022-4854
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Country | US
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Telephone | 770-667-8060
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Fax | 770-667-2024
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Provider Business Mailing Address
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Address Line | 434 LEGACY OAKS CIR
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City | ROSWELL
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State | GA
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Zip | 30076-4828
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Country | US
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Telephone | 770-674-4061
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Fax | 770-674-4061
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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 | OPT002391
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License Number State | GA
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