MEDICARE: DR. LINDSAY JORDAN ARMAGON OD

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
1	152W00000X	Optometrist	OPT003054	GA

General Provider Information

NPI Number	:	1396263026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDSAY JORDAN ARMAGON OD

Provider Business Mailing Address
First Line	:	5250 HIGHWAY 138 APT 3423
Second Line	:
City	:	UNION CITY
State	:	GA
Zip	:	30291-6521
Country	:	US
Telephone Number	:	404-276-5491
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 COMMERCE AVE BLDG 2200
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	404-275-5491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2017
Last Update Date	:	09/01/2017

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