Individual
DR. PHI PHI BANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1675 CUMBERLAND PKWY SE, SUITE #103, SMYRNA, GA 30080-6359
(770) 438-0202
Mailing address
15933 CLAYTON RD, SUITE 201, BALLWIN, MO 63011-2172
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2015
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52052995000
BLUE CROSS BLUE SHIELD
GA
Enumeration date
09/26/2006
Last updated
01/24/2017
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