Organization
MARTIN K WOOTEN OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN K WOOTEN OD (PRESIDENT)
(706) 374-2020
Entity
Organization
Contact information
Practice address
106 MAPLE ST, MORGANTON, GA 30560-3716
(706) 374-2020
(706) 374-1199
Mailing address
PO BOX 427, MORGANTON, GA 30560-0427
(706) 374-2020
(706) 374-1199
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001302
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000484855A
—
GA
Enumeration date
11/17/2011
Last updated
11/17/2011
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