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NPI Code Detail

MEDICARE: REBECCA M ATKINSON OD

MEDICARE: REBECCA M ATKINSON 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
1152W00000XOptometrist1307DTKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437157112
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA M ATKINSON OD
Provider Business Mailing Address
First Line : 711 GREENLEAF CT
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-1287
Country : US
Telephone Number : 270-307-6762
Fax Number :
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-3507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 12/21/2023

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