Basic Information
| Provider Information | |||||||||
| NPI: | 1205886728 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOJNO | ||||||||
| FirstName: | TED | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1365B CLIFTON RD NE | ||||||||
| Address2: | BUILDING B RM 4500 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047783457 | ||||||||
| FaxNumber: | 4047785128 | ||||||||
| Practice Location | |||||||||
| Address1: | 1365B CLIFTON RD NE | ||||||||
| Address2: | BUILDING B RM 4500 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047783420 | ||||||||
| FaxNumber: | 4047785128 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 026959 | GA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.