Provider Demographics
NPI:1235163288
Name:ALAMEDDINE, HADI (OD)
Entity Type:Individual
Prefix:DR
First Name:HADI
Middle Name:
Last Name:ALAMEDDINE
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 1:3030 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3782
Mailing Address - Country:US
Mailing Address - Phone:706-866-2247
Mailing Address - Fax:706-866-2247
Practice Address - Street 1:3030 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3782
Practice Address - Country:US
Practice Address - Phone:706-866-2247
Practice Address - Fax:706-866-2247
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000OPT001843152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA41ZCFTDMedicare PIN
GAU85790Medicare UPIN