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General NPI Number Information
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NPI Number | 1689409898
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Entity Type | Organization
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Legal Business Name | CROWDER & ADAMS OPTOMETRIC CORP
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 1895 BATTLEFIELD PKWY
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City | FORT OGLETHORPE
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State | GA
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Zip | 30742-4021
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Country | US
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Telephone | 706-861-7166
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Fax |
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Provider Business Mailing Address
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Address Line | 1895 BATTLEFIELD PKWY
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City | FORT OGLETHORPE
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State | GA
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Zip | 30742-4021
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Country | US
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Telephone | 706-861-7166
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | JOSHUA CROWDER
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Credential | OD
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Telephone | 706-861-7166
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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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