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General NPI Number Information
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NPI Number | 1770770539
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Entity Type | Organization
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Legal Business Name | SEAN CARR, O.D., P.C.
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 8 BULLSBORO DR
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City | NEWNAN
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State | GA
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Zip | 30263-1476
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Country | US
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Telephone | 770-254-9996
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Fax | 770-252-0050
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Provider Business Mailing Address
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Address Line | 8 BULLSBORO DR
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City | NEWNAN
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State | GA
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Zip | 30263-1476
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Country | US
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Telephone | 770-254-9996
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Fax | 770-252-0050
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Authorized Official
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Title or Position | OPTOMETRIST/PARTNER
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Name | DR. GRANT PAUL MACDONALD
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Credential | O.D.
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Telephone | 770-254-9996
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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 | 1560
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License Number State | GA
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