MEDICARE: A&A OPTICAL LLC

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

General Provider Information

NPI Number	:	1609598846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&A OPTICAL LLC

Provider Business Mailing Address
First Line	:	1670 BATTLEFIELD PKWY
Second Line	:
City	:	FORT OGLETHORPE
State	:	GA
Zip	:	30742-4046
Country	:	US
Telephone Number	:	706-866-2111
Fax Number	:	706-866-5363

Provider Business Practice Location Address
First Line	:	1670 BATTLEFIELD PKWY
Second Line	:
City	:	FORT OGLETHORPE
State	:	GA
Zip	:	30742-4046
Country	:	US
Telephone Number	:	706-866-2111
Fax Number	:	706-866-5363

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SULICIA L JONES
Credential	:	LDO
Telephone Number	:	706-866-2111

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	09/14/2022

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Directions to “A&A OPTICAL LLC ” Practice Location

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