Organization
JING DONG MD PC
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
5 S MCINTOSH ST, ELBERTON, GA 30635-2465
(706) 283-7510
(706) 283-7570
Mailing address
5 SOUTH MCINTOSH STREET, ELBERTON, GA 30635
(706) 546-9290
(706) 546-4938
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT002405
GA
152W00000X
Optometrist
OPT002596
GA
207W00000X
Ophthalmology Physician
Primary
045447
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000791568J
—
GA
Enumeration date
05/12/2014
Last updated
02/28/2023
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