Carson, Stacy U
Carson, Stacy U is an individual health care provider with primary practice located at 805 Commerce Dr Sw Suite A, Conyers GA 30094-6606. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Carson, Stacy U can be contacted via phone (770) 483-4831.Contact Information
Primary practice address
805 Commerce Dr Sw Suite A
Conyers GA 30094-6606
Phone: (770) 483-4831
Fax: (770) 483-4840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1622 | Georgia |
Profile Details
| NPI number | 1871530964 |
|---|---|
| LBN Legal business name | Carson, Stacy U |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Nov 22nd, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871530964 | NPPES |
| Georgia | Other | 5801653 | AETNA |
| Georgia | Other | 410036767 | AETNA |
| Georgia | Other | 52718823001 | AETNA |
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