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Organization

SUZANNE KIMMONS, OD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUZANNE KIMMONS-DOTY OD (OPTOMETRIST)
(706) 216-7732
Entity
Organization

Contact information

Practice address
6628 HIGHWAY 53 E, DAWSONVILLE, GA 30534-6806
(706) 216-7732
(706) 216-7733
Mailing address
6628 HIGHWAY 53 E, DAWSONVILLE, GA 30534-6806
(706) 216-7732
(706) 216-7733

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
T1164
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP4825
MEDICARE GROUP
GA
Enumeration date
11/02/2007
Last updated
03/20/2008
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