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General NPI Number Information
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NPI Number | 1962887521
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Entity Type | Organization
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Legal Business Name | WOODHAMS OPTICAL, LLC
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 1140 HAMMOND DR SUITE E5100
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City | ATLANTA
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State | GA
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Zip | 30328-5338
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Country | US
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Telephone | 770-394-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 HAMMOND DR SUITE E5100
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City | ATLANTA
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State | GA
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Zip | 30328-5338
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Country | US
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Telephone | 770-394-4000
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DEDE DEAN
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Credential |
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Telephone | 770-394-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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