Provider Demographics
NPI:1215023809
Name:CHANDLER-MORGAN, ROBIN RAE (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:RAE
Last Name:CHANDLER-MORGAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:RAE
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 1225
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-1225
Mailing Address - Country:US
Mailing Address - Phone:229-924-9998
Mailing Address - Fax:229-924-9991
Practice Address - Street 1:208 E LAMAR ST
Practice Address - Street 2:SUITE B
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3694
Practice Address - Country:US
Practice Address - Phone:229-928-2024
Practice Address - Fax:229-928-2921
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2315152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
511I410092Medicare PIN