Individual
DR. WILLIAM R. SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
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
152W00000X
Optometrist
Primary
T964
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0786430001
DURABLE MEDICAL EQUIPMENT
GA
Enumeration date
03/28/2007
Last updated
07/08/2007
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