Provider Demographics
NPI:1417434853
Name:PARIKH, MANSI (OD)
Entity Type:Individual
Prefix:DR
First Name:MANSI
Middle Name:
Last Name:PARIKH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 BLUE STONE RD UNIT 3009
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3860
Mailing Address - Country:US
Mailing Address - Phone:770-992-5900
Mailing Address - Fax:
Practice Address - Street 1:3100 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5657
Practice Address - Country:US
Practice Address - Phone:770-992-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003114152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist