Search › Georgia › Optometrist
Derek Black, O.D
NPI 1114353232 · on the registry since 2013
Practice
- Address
- 1211 Bald Ridge Marina Rd
Cumming, GA 30041 - Phone
- (470) 239-6625
- Fax
- (470) 239-6626
- Organisation at this address
- Costco Wholesale Corporation
Costco Wholesale Corporation
Costco Wholesale CorporationInferred from a shared address, not stated in the registry. - Clinicians at this address
- 3
Additional practice sites
- 9300 Dewitt Loop, Fort Belvoir, VA
Registry record
- Primary taxonomy
- Optometrist
152W00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-10-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia