Individual
RONALD BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1615 RIDENOUR BLVD NW, 201, KENNESAW, GA 30152-4464
(770) 499-2020
(770) 426-8157
Mailing address
1615 RIDENOUR BLVD NW, 201, KENNESAW, GA 30152-4463
(770) 499-2020
(770) 426-8157
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
661
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
581298372
EYEMED
GA
Enumeration date
03/20/2007
Last updated
08/29/2013
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