Provider Demographics
NPI:1033396379
Name:MARCHBANKS, GEORGE ALEX (OD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALEX
Last Name:MARCHBANKS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TURTLE CREEK DRIVE
Mailing Address - Street 2:SUITE #450
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402
Mailing Address - Country:US
Mailing Address - Phone:601-261-2223
Mailing Address - Fax:
Practice Address - Street 1:1000 TURTLE CREEK DRIVE
Practice Address - Street 2:SUITE #450
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:601-261-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS538152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist