Search › Georgia › 156FX1800X
Otis Weaver, LICENSED OPTICIAN
NPI 1801292016 · on the registry since 2014 · sole proprietor
Practice
- Address
- 4765 Memorial Dr
Decatur, GA 30032 - Phone
- (404) 296-2307
- Organisation at this address
- Mary N, Brunner, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 156FX1800X
156FX1800X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-11-16
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