Provider Demographics
NPI:1467661660
Name:EADS, NATALIE LAND (OD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:LAND
Last Name:EADS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:RENE'
Other - Last Name:LAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1083 QUEENSGATE DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-6400
Mailing Address - Country:US
Mailing Address - Phone:404-512-0785
Mailing Address - Fax:
Practice Address - Street 1:1100 JOHNSON FERRY RD NE
Practice Address - Street 2:BUILDING 1 SUITE 140
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1709
Practice Address - Country:US
Practice Address - Phone:404-531-9988
Practice Address - Fax:404-531-9488
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002198152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist