Organization
ADVANCED EYECARE OF GEORGIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WILLIAM BALDWIN O.D. (PRESIDENT)
(770) 233-6860
Entity
Organization
Contact information
Practice address
1569 N EXPRESSWAY, GRIFFIN, GA 30223-1746
(770) 233-6860
Mailing address
1118 HILLTOP DR, GRIFFIN, GA 30224-4937
(770) 233-6860
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
819T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55413554SA
—
GA
Enumeration date
10/01/2006
Last updated
08/27/2008
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