Organization
OPTOMETRY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SMITESH JAY PATEL (PRESIDENT)
(706) 507-3937
Entity
Organization
Contact information
Practice address
9220 MARNE RD, FORT BENNING, GA 31905-5515
(706) 682-3938
(706) 682-3931
Mailing address
312 CASCADE CT, COLUMBUS, GA 31904-2805
(706) 593-0709
(706) 682-3931
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GA OPT1868
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404896730A
—
GA
Enumeration date
03/09/2009
Last updated
08/23/2022
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