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NPI Code Detail

MEDICARE: DR. TERRY H. WYNNE, OPTOMETRIST, P.C.

MEDICARE: DR. TERRY H. WYNNE, OPTOMETRIST, P.C.
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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1871762823
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. TERRY H. WYNNE, OPTOMETRIST, P.C.
Provider Business Mailing Address
First Line : 112 W OAK ST
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4233
Country : US
Telephone Number : 770-227-2924
Fax Number : 770-227-2937
Provider Business Practice Location Address
First Line : 112 W OAK ST
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4233
Country : US
Telephone Number : 770-227-2924
Fax Number : 770-227-2937
Authorized Official
Title or Position : DOCTOR
Name : DR. TERRY H. WYNNE
Credential :
Telephone Number : 770-227-2924
Provider Enumeration Date : 02/25/2008
Last Update Date : 09/28/2010

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Directions to “DR. TERRY H. WYNNE, OPTOMETRIST, P.C. ” Practice Location

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