Provider Demographics
NPI:1467459057
Name:EGHIGIAN, DAVID SASSOUNI (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SASSOUNI
Last Name:EGHIGIAN
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 1:1620 PRINCE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6008
Mailing Address - Country:US
Mailing Address - Phone:706-546-0170
Mailing Address - Fax:
Practice Address - Street 1:1030 FOUNDERS ROW STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-5260
Practice Address - Country:US
Practice Address - Phone:706-546-0170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003478152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2201326OtherUNITED HEALTH CARE
IL08232030OtherBLUE CROSS BLUE SHIELD
IL3551648OtherAETNA
IL3551648OtherAETNA
IL544020Medicare ID - Type Unspecified