Individual
DR. TIMOTHY GLENN SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
9550 JONES BRIDGE RD, SUITE 200, ALPHARETTA, GA 30022
(770) 475-1242
(770) 475-1032
Mailing address
4330 JOHNS CREEK PKWY, SUITE 300, SUWANEE, GA 30024-6120
(770) 232-7844
(770) 232-9455
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001255
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000493347B
—
GA
01
—
1912195272
GROUP NPI
GA
01
—
GRP4578
MEDICARE GROUP
GA
Enumeration date
03/25/2006
Last updated
09/25/2008
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