Provider Demographics
NPI:1598310286
Name:ROBBINS, CONNER MILLWOOD (OD)
Entity Type:Individual
Prefix:
First Name:CONNER
Middle Name:MILLWOOD
Last Name:ROBBINS
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 1:400 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:31833-1522
Mailing Address - Country:US
Mailing Address - Phone:706-643-2020
Mailing Address - Fax:706-643-2022
Practice Address - Street 1:400 3RD AVE
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833-1522
Practice Address - Country:US
Practice Address - Phone:706-643-2020
Practice Address - Fax:706-643-2022
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003198152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist