Individual
SHUNDALE THOMAS MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1300 PEACHTREE INDUSTRIAL BLVD STE 1206, SUWANEE, GA 30024-4550
(334) 318-0713
Mailing address
1300 PEACHTREE INDUSTRIAL BLVD STE 1206, SUWANEE, GA 30024-4550
(770) 783-2162
(770) 783-2165
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003111
GA
Other
Enumeration date
07/02/2018
Last updated
10/04/2023
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