Individual
EDWARD THEODORE WASHINGTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4045 WETHERBURN WAY STE 1, NORCROSS, GA 30092-4611
(770) 285-7910
Mailing address
4045 WETHERBURN WAY STE 1, NORCROSS, GA 30092-4611
(770) 285-7010
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
312393
LA
207W00000X
Ophthalmology Physician
57027483
OH
207W00000X
Ophthalmology Physician
TP126
KY
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
91739
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039071
—
IN
05
—
7100669250
—
KY
Enumeration date
04/05/2015
Last updated
08/30/2023
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