Individual
THOMAS J ROSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1276 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3823
(770) 532-7246
(770) 532-2683
Mailing address
1276 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3823
(770) 532-7246
(770) 532-2683
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
915T
GA
152WC0802X
Corneal and Contact Management Optometrist
915T
GA
152WX0102X
Occupational Vision Optometrist
915T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00339006B
—
GA
01
—
2230017
UNITED HEALTHCARE
GA
01
—
300028600A
MEDICAID PAYEE PROVIDER
GA
01
—
541054
US HEALTHCARE
GA
Enumeration date
01/11/2007
Last updated
02/14/2008
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