Provider Demographics
NPI:1134307168
Name:WILLIAMS GIEDD & ASSOCIATES OD PA
Entity Type:Organization
Organization Name:WILLIAMS GIEDD & ASSOCIATES OD PA
Other - Org Name:EOLA EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGHID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-447-7739
Mailing Address - Street 1:519 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5313
Mailing Address - Country:US
Mailing Address - Phone:407-447-7739
Mailing Address - Fax:407-896-6547
Practice Address - Street 1:519 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5313
Practice Address - Country:US
Practice Address - Phone:407-447-7739
Practice Address - Fax:407-896-6547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
921002884327-001Medicare UPIN
CV163AMedicare PIN