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General NPI Number Information
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NPI Number | 1902045602
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Entity Type | Organization
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Legal Business Name | DON R DYE OD
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 11/11/2011
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Provider Practice Location Address
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Address Line | 17 S THOMAS ST
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City | ELBERTON
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State | GA
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Zip | 30635-2453
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Country | US
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Telephone | 706-283-2351
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Fax | 706-283-3610
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Provider Business Mailing Address
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Address Line | 17 S THOMAS ST
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City | ELBERTON
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State | GA
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Zip | 30635-2453
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Country | US
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Telephone | 706-283-2351
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Fax | 706-283-3610
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Authorized Official
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Title or Position | OWNER
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Name | DR. DON R DYE
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Credential |
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Telephone | 706-283-2351
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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 | OPT000695
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License Number State | GA
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