Individual
KRYSTAL L PUSSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2817 REILLY ST, WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-7324
(910) 907-8922
(910) 907-6069
Mailing address
2817 REILLY ST, WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-7324
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001348
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606537A
—
GA
05
—
000606537D
—
GA
05
—
000606537E
—
GA
05
—
000606537F
—
GA
01
—
000606537G
MEDICAID- BORO
GA
01
—
000606537H
MEDICAID - RINCON
GA
01
—
08525
SPECTERA
GA
01
—
111065
NATL VISION ADMIN
GA
01
—
1992735815
MEDICARE RAILROAD
GA
01
—
511G701032
GA MEDICARE GROUP
GA
01
—
52484359
STATE HEALTH PLAN
GA
01
—
732348
BCBS
GA
01
—
P00013749
RAILROAD MEDICARE
GA
Enumeration date
07/04/2006
Last updated
02/17/2017
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