Individual
GEORGE WILLIAM DOOLIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
417A RACETRACK RD NW, FORT WALTON BEACH, FL 32547-4600
(850) 315-8861
(850) 864-2844
Mailing address
15933 CLAYTON RD, SUITE 201, BALLWIN, MO 63011-2172
(636) 200-4393
(636) 527-0838
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1405
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19465
BLUECROSSBLUESHIELD
FL
01
—
593537436
TRICARE
FL
01
—
A11078
EYEMED
—
Enumeration date
06/22/2005
Last updated
08/03/2017
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