Organization
KELLY H NILSSON, OD, PA
Active
Other names
Nilsson Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY HONSINGER NILSSON OD (PRESIDENT)
(601) 347-1725
Entity
Organization
Contact information
Practice address
3580 MASSEE LN STE G, COLUMBUS, GA 31909-2586
(762) 583-6110
Mailing address
320 STEELE CREEK DR, MIDLAND, GA 31820-4647
(601) 347-1725
(706) 682-3931
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4662
FL
152W00000X
Optometrist
842
MS
152W00000X
Optometrist
OPT002997
GA
152W00000X
Optometrist
—
AL
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A10819
EYEMED
—
Enumeration date
10/11/2012
Last updated
08/26/2021
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