Provider Demographics
NPI:1114379492
Name:PATEL, SONYA (OD)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 S COBB DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7180
Mailing Address - Country:US
Mailing Address - Phone:770-863-9421
Mailing Address - Fax:770-863-9427
Practice Address - Street 1:1133 E WEST CONNECTOR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1779
Practice Address - Country:US
Practice Address - Phone:770-863-9421
Practice Address - Fax:770-863-9427
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist