Ellsworth, Tyler William
Ellsworth, Tyler William is an sole proprietor health care provider with primary practice located at 8075 Mall Pkwy Ste 103 , Lithonia GA 30038-6993. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ellsworth, Tyler William can be contacted via phone (770) 484-2955.Contact Information
Primary practice address
8075 Mall Pkwy Ste 103
Lithonia GA 30038-6993
Phone: (770) 484-2955
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT003180 | Georgia |
Profile Details
| NPI number | 1760034110 |
|---|---|
| LBN Legal business name | Ellsworth, Tyler William |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 15th, 2019 |
| Last updated | Jul 15th, 2019 - about 7 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.
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