Individual
DR. TIMOTHY ADKINS ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4521 17TH AVE, COLUMBUS, GA 31904
(706) 660-0191
(706) 596-8388
Mailing address
4521 17TH AVE, COLUMBUS, GA 31904
(706) 660-0191
(706) 596-8388
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001089
GA
152WC0802X
Corneal and Contact Management Optometrist
OPT001089
GA
152WL0500X
Low Vision Rehabilitation Optometrist
OPT001089
GA
152WP0200X
Pediatric Optometrist
OPT001089
GA
152WS0006X
Sports Vision Optometrist
OPT001089
GA
152WV0400X
Vision Therapy Optometrist
OPT001089
GA
152WX0102X
Occupational Vision Optometrist
OPT001089
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00584075A
—
GA
01
—
1107013
UNITED HEALTHCARE
GA
01
—
11473020
CAQH
—
Enumeration date
07/10/2006
Last updated
06/03/2019
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