Spence, Timothy Glenn
Spence, Timothy Glenn is an individual health care provider with primary practice located at 9550 Jones Bridge Rd Suite 200, Alpharetta GA 30022. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Spence, Timothy Glenn can be contacted via phone (770) 475-1242.Contact Information
Primary practice address
9550 Jones Bridge Rd Suite 200
Alpharetta GA 30022
Phone: (770) 475-1242
Fax: (770) 475-1032
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT001255 | Georgia |
Profile Details
| NPI number | 1073573788 |
|---|---|
| LBN Legal business name | Spence, Timothy Glenn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 25th, 2006 |
| Last updated | Sep 25th, 2008 - about 18 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 | 1073573788 | NPPES |
| Georgia | Other | GRP4578 | MEDICARE GROUP |
| Georgia | Other | 1912195272 | MEDICARE GROUP |
| Georgia | MEDICAID | 000493347B | MEDICARE GROUP |
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