Individual
DENNIS LEE COWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
207 CHESTNUT ST, BREMEN, GA 30110-2021
(770) 537-5246
(770) 537-1313
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000902
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000204256A
—
GA
01
—
009915685
ALABAMA MEDICAID
GA
Enumeration date
08/31/2007
Last updated
07/14/2021
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