Organization
JING DONG M.D. P.C.
Active
Other names
Georgia Center for Sight
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE B DAVIS (CHIEF REVENUE CYCLE OFFICER)
(916) 990-7590
Entity
Organization
Contact information
Practice address
651 S MILLEDGE AVE, ATHENS, GA 30605-1250
(706) 546-9290
(706) 546-4938
Mailing address
651 SOUTH MILLEDGE AVE, ATHENS, GA 30605
(706) 546-9290
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
045447
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000791568H
—
GA
01
—
1164833380
NPI
GA
01
—
1578729075
NPI
GA
01
—
1649681768
NPI
GA
01
—
5755300002
MEDICARE PTAN
GA
01
—
5755300003
MEDICARE PTAN
GA
Enumeration date
08/04/2008
Last updated
02/28/2023
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