Individual
DR. DAVID JACKSON WAYLAND SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3975 OLD MILTON PKWY, STE2, ALPHARETTA, GA 30005-4467
(678) 624-7766
(678) 624-7775
Mailing address
1950 OLD GALLOWS RD, STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001624
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00919322A
—
GA
Enumeration date
10/18/2006
Last updated
02/16/2018
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