Individual
JAMES T HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1841 N COLUMBIA ST, MILLEDGEVILLE, GA 31061-2382
(478) 452-3593
(478) 453-0016
Mailing address
1841 N COLUMBIA ST, MILLEDGEVILLE, GA 31061-2382
(478) 452-3593
(478) 453-0016
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001328
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00624247A
—
GA
01
—
100922
AVESIS M'CAID
GA
01
—
41292
AVESIS
GA
01
—
44334
SPECTERA
GA
Enumeration date
12/14/2006
Last updated
07/08/2007
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