Organization
MIDTOWNE VISION CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRIAM D TURNER OD (OFFICE ADMINISTRATOR)
(478) 803-0001
Entity
Organization
Contact information
Practice address
635 PIO NONO AVE, MACON, GA 31204-3531
(478) 803-0001
(478) 254-4997
Mailing address
635 PIO NONO AVE, MACON, GA 31204-3531
(478) 803-0001
(478) 254-4997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002520
GA
152W00000X
Optometrist
Primary
1471
GA
152WP0200X
Pediatric Optometrist
002520
GA
152WP0200X
Pediatric Optometrist
1471
GA
152WV0400X
Vision Therapy Optometrist
002520
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000687981G
—
GA
01
—
U746489
UPIN
GA
Enumeration date
10/26/2009
Last updated
09/30/2011
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