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General NPI Number Information
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NPI Number | 1669550034
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Entity Type | Individual
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Provider Name | SHEILA ANN GOWDY OD
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 9412 PARKWOOD AVE
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City | DOUGLASVILLE
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State | GA
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Zip | 30135
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Country | US
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Telephone | 770-920-9144
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Fax | 770-987-6828
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Provider Business Mailing Address
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Address Line | 9412 PARKWOOD AVE
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City | DOUGLASVILLE
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State | GA
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Zip | 30135
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Country | US
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Telephone | 770-920-9144
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Fax | 770-987-6828
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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 | 001760
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 006074
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License Number State | NY
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