Organization
GEORGE W WALTERS JR
Active
Other names
Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE WATKINS WALTERS JR. O.D. (OPTOMETRIST)
(731) 658-5197
Entity
Organization
Contact information
Practice address
725 W MARKET ST, BOLIVAR, TN 38008-2242
(731) 658-5197
(731) 658-5245
Mailing address
725 W MARKET ST, BOLIVAR, TN 38008-2242
(731) 658-5197
(731) 658-5245
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000000654
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3594030
—
TN
Enumeration date
08/31/2015
Last updated
08/31/2015
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