Organization
WILLIAM R. SHOCKLEY, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM SHOCKLEY OD (OWNER/OPTOMETRIST)
(770) 254-0200
Entity
Organization
Contact information
Practice address
47 JEFFERSON ST, NEWNAN, GA 30263-1948
(770) 254-0200
(770) 254-1281
Mailing address
47 JEFFERSON ST, NEWNAN, GA 30263-1948
(770) 254-0200
(770) 254-1281
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0786430001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000443484B
—
GA
Enumeration date
03/31/2008
Last updated
07/16/2008
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