Individual
STEPHEN D SUMMEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
216 CORDER RD, WARNER ROBINS, GA 31088
(478) 923-5872
(478) 922-9020
Mailing address
216 CORDER RD, WARNER ROBINS, GA 31088-3604
(478) 322-4107
(478) 922-9020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1591
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000764189Y
—
GA
05
—
00764189R
—
GA
Enumeration date
03/09/2007
Last updated
06/13/2018
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