Provider Demographics
NPI:1164566931
Name:MCGHEE, ROBIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:MCGHEE OD PC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2175 MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-1035
Mailing Address - Country:US
Mailing Address - Phone:770-413-4111
Mailing Address - Fax:770-469-3201
Practice Address - Street 1:1825 ROCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3335
Practice Address - Country:US
Practice Address - Phone:770-413-4111
Practice Address - Fax:770-938-9913
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1244152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003123154AMedicaid
GA412CCGRMedicare ID - Type Unspecified
GA003123154AMedicaid