Provider Demographics
NPI:1578765616
Name:SEAN CARR OD, PC.
Entity Type:Organization
Organization Name:SEAN CARR OD, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-254-9997
Mailing Address - Street 1:20 BAKER RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2134
Mailing Address - Country:US
Mailing Address - Phone:770-254-9997
Mailing Address - Fax:770-254-0134
Practice Address - Street 1:20 BAKER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2134
Practice Address - Country:US
Practice Address - Phone:770-254-9997
Practice Address - Fax:770-254-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7331Medicare PIN
GA5984180002Medicare NSC