Individual
DR. CLINT D PAXSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1014 NORTHSIDE DR E, STATESBORO, GA 30458-1002
(912) 764-9147
(912) 764-3250
Mailing address
1014 NORTHSIDE DR E, STATESBORO, GA 30458-1002
(912) 764-9147
(912) 764-3250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1401
SC
152W00000X
Optometrist
Primary
OPT002932
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003219828A
—
GA
05
—
D14018
—
SC
Enumeration date
02/27/2006
Last updated
10/20/2022
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