Provider Demographics
NPI:1225261977
Name:DASINGER, MICHAEL CRAIG (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CRAIG
Last Name:DASINGER
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 1:5983 HIGHWAY 53 E
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-9513
Mailing Address - Country:US
Mailing Address - Phone:334-618-0930
Mailing Address - Fax:
Practice Address - Street 1:5983 HIGHWAY 53 E
Practice Address - Street 2:SUITE 250
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-9513
Practice Address - Country:US
Practice Address - Phone:334-618-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C12-TA-825152W00000X
TN2920152W00000X
GAOPT002849152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0416100001Medicare NSC