Provider Demographics
NPI:1073515771
Name:COMER, HOWARD EMRI (OD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:EMRI
Last Name:COMER
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 1:40 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3774
Mailing Address - Country:US
Mailing Address - Phone:912-261-0788
Mailing Address - Fax:912-261-0760
Practice Address - Street 1:40 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-3774
Practice Address - Country:US
Practice Address - Phone:912-261-0788
Practice Address - Fax:912-261-0760
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1233T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00445167DMedicaid
GA00445167DMedicaid
GA0135120001Medicare NSC
GAU14293Medicare UPIN