Individual
NORMAN LYLE LASTINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
641 HIGHWAY 341 S, BARNESVILLE, GA 30204-1555
(770) 358-1010
(770) 358-9132
Mailing address
PO BOX 1438, BYRON, GA 31008-1438
(770) 358-1010
(770) 358-9132
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001094
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000357926-G
—
GA
01
—
4016810001
CMS - MEDICARE SUPPLIER #
GA
Enumeration date
10/03/2005
Last updated
03/13/2026
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