NPI 1336199413

Regina McCollum Sullivan, OD

Practitioner Optometrist Norcross, GA

Practice location

Address: 1560 Indian Trail Rd Suite 108, Norcross, GA 30093-2613
Phone: (770) 923-1011
Fax: (770) 923-1041
Mailing address: 1560 Indian Trail Rd Suite 108, Norcross, GA 30093-2666

Registered specialties (4)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence GA1647 (GA)

Other Optometrist providers in Georgia →

Corneal and Contact Management Optometrist

Eye and Vision Services Providers Taxonomy 152WC0802X Licence GA1647 (GA)

Pediatric Optometrist

Eye and Vision Services Providers Taxonomy 152WP0200X Licence GA1647 (GA)

Vision Therapy Optometrist

Eye and Vision Services Providers Taxonomy 152WV0400X Licence GA1647 (GA)

Registry record

NPI: 1336199413
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 May 2006
Record last updated: 3 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.