Provider Demographics
NPI:1568607224
Name:BURNS, VERA E (OD)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:E
Last Name:BURNS
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 1:3191 KEY DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-3648
Mailing Address - Country:US
Mailing Address - Phone:404-388-4321
Mailing Address - Fax:
Practice Address - Street 1:4135 LAVISTA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5314
Practice Address - Country:US
Practice Address - Phone:404-388-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1007T152W00000X
GAOPT001007152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist