Provider Demographics
NPI:1306946496
Name:GIGLIOTTI, ROBERT F (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:GIGLIOTTI
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 1:5485 BETHELVIEW RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9737
Mailing Address - Country:US
Mailing Address - Phone:678-513-8686
Mailing Address - Fax:
Practice Address - Street 1:5485 BETHELVIEW RD STE 320
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-9737
Practice Address - Country:US
Practice Address - Phone:678-513-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1644152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I412401OtherPTAN