MEDICARE: DR. GEORGE ALEXANDER GARRETT O.D.

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	943-T	GA
2	152W00000X	Optometrist	S-466	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51502048GAR	OTHER	AL	BC/BS - ALABAMA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609952589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ALEXANDER GARRETT O.D.

Provider Business Mailing Address
First Line	:	PO BOX 589
Second Line	:
City	:	HAMILTON
State	:	GA
Zip	:	31811-0589
Country	:	US
Telephone Number	:	706-628-5720
Fax Number	:	706-884-2804

Provider Business Practice Location Address
First Line	:	121 DOGWOOD LANE
Second Line	:
City	:	HAMILTON
State	:	GA
Zip	:	31811-0589
Country	:	US
Telephone Number	:	706-628-5720
Fax Number	:	706-884-2804

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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