Thomas, Stuart Jackson

Thomas, Stuart Jackson is an individual health care provider with primary practice located at 1077 Baxter St , Athens GA 30606-3767. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Thomas, Stuart Jackson can be contacted via phone (706) 549-7757.

Contact Information

Primary practice address
1077 Baxter St Athens GA 30606-3767
Phone: (706) 549-7757
Fax: (706) 549-4186
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Sports Vision 152WS0006X GA 1062 Georgia
Eye and Vision Services Providers / Optometrist 152W00000X GA1062 Georgia

Profile Details

NPI number 1568436186
LBN Legal business name Thomas, Stuart Jackson
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Dec 9th, 2013 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1568436186 NPPES
Georgia MEDICAID 00314388A

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