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General NPI Number Information
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NPI Number | 1962561928
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Entity Type | Organization
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Legal Business Name | BATTLEFIELD OPTICAL DISPENSARY
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 1052 BATTLEFIELD PKWY
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City | FT OGLETHORPE
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State | GA
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Zip | 30742-3948
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Country | US
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Telephone | 706-866-2020
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Fax | 706-866-6890
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Provider Business Mailing Address
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Address Line | 1052 BATTLEFIELD PARKWAY
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City | FT OGLETHORPE
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State | GA
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Zip | 30742
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Country | US
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Telephone | 706-866-2020
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Fax | 706-866-6890
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Authorized Official
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Title or Position | OWNER
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Name | MR. EDWIN T HULSE
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Credential | MD
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Telephone | 706-866-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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