Organization
BLUE LASER GROUP
Active
Other names
Blue Laser Group
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD HOWARD BLUE M.D. (OPTHALMOLOGIST)
(706) 549-0005
Entity
Organization
Contact information
Practice address
1747 LANGFORD DRIVE, BUILDING 400, SUITE 101, BOGART, GA 30622
(706) 549-0005
(706) 850-3180
Mailing address
1747 LANGFORD DRIVE, BUILDING 400, SUITE 101, BOGART, GA 30622
(706) 549-0005
(706) 850-3180
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
027348
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00301793A
—
GA
01
—
027348
GA LICENCE
GA
Enumeration date
06/26/2006
Last updated
03/07/2023
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