Individual
DR. ERIC M KOLISZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4380 KINGS WAY, VALDOSTA, GA 31602-6921
(229) 391-4126
(229) 391-4392
Mailing address
4380 KINGS WAY, VALDOSTA, GA 31602-6921
(229) 391-4126
(229) 391-4392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001943
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07566
SPECTERA
GA
01
—
081184001
CIGNA/PALMETTO DME
GA
01
—
44257
AVESIS GROUP
GA
01
—
92033
AVESIS MEDICAID
GA
Enumeration date
03/21/2006
Last updated
09/06/2013
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