Basic Information
| Provider Information | |||||||||
| NPI: | 1235332859 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SHARI, LTD | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE EYE DOCTORS VISION CORRECTION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030 13TH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319012240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063278181 | ||||||||
| FaxNumber: | 7065966658 | ||||||||
| Practice Location | |||||||||
| Address1: | 1030 13TH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319012240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063278181 | ||||||||
| FaxNumber: | 7065966658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GOLD | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7063278181 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.