Individual
GERALD W. KOSS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
90 VILLAGE AT GLYNN PL, BRUNSWICK, GA 31525-1993
(912) 264-6000
(912) 264-6080
Mailing address
90 VILLAGE AT GLYNN PL, BRUNSWICK, GA 31525-1993
(912) 264-6000
(912) 264-6080
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2249
GA
152W00000X
Optometrist
4033
FL
152W00000X
Optometrist
OPT002249
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
959951220A
—
GA
05
—
959951220B
—
GA
Enumeration date
11/01/2006
Last updated
01/08/2014
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