Individual
DR. JOHN THOMAS WOMACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1455 RIVERSTONE PKWY STE 100, CANTON, GA 30114-5627
(770) 479-0500
(770) 720-0104
Mailing address
1455 RIVERSTONE PKWY STE 100, CANTON, GA 30114-5627
(770) 479-0500
(770) 720-0104
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002064
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28579
BCBS
FL
01
—
28579A
BCBS
—
Enumeration date
06/05/2006
Last updated
05/20/2025
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