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Individual

DR. IRBY DELL ENGRAM JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1455 HWY 441 SOUTH, CLAYTON, GA 30525
(706) 782-6961
(706) 782-6966
Mailing address
PO BOX 848, CLAYTON, GA 30525-0022
(770) 337-5966

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1398
SC
152W00000X
Optometrist
Primary
OPT000655
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00057967A
GA
01
25977
AVESIS
05
89093NT
NC
Enumeration date
10/04/2006
Last updated
03/31/2026
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