Organization
TED A MCELROY OD, PC
Active
Other names
Vision Source Tifton
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TED A MCELROY OD (PRESIDENT)
(229) 382-4765
Entity
Organization
Contact information
Practice address
2012 PINEVIEW AVE, TIFTON, GA 31794-3035
(229) 382-4765
(229) 382-4819
Mailing address
PO BOX 1186, TIFTON, GA 31793-1186
(229) 382-4765
(229) 382-4819
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GA1397
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031267A
—
GA
01
—
410029773
MEDICARE RAILROAD
GA
Enumeration date
11/30/2006
Last updated
09/21/2012
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