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NPI Code Detail

MEDICARE: MR. PHILIP FRIEDLAND LDO

MEDICARE:  MR. PHILIP  FRIEDLAND  LDO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician001503GA

General Provider Information

NPI Number : 1326018458
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PHILIP FRIEDLAND LDO
Provider Business Mailing Address
First Line : 3700 ATLANTA HWY
Second Line :
City : ATHENS
State : GA
Zip : 30606-7201
Country : US
Telephone Number : 706-543-7925
Fax Number : 706-546-9025
Provider Business Practice Location Address
First Line : 3700 ATLANTA HWY
Second Line :
City : ATHENS
State : GA
Zip : 30606-7201
Country : US
Telephone Number : 706-543-7925
Fax Number : 706-546-9025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 07/08/2007

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Directions to “ MR. PHILIP FRIEDLAND LDO” Practice Location

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