Provider Demographics
NPI:1609598846
Name:A&A OPTICAL LLC
Entity Type:Organization
Organization Name:A&A OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SULICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:706-866-2111
Mailing Address - Street 1:1670 BATTLEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-4046
Mailing Address - Country:US
Mailing Address - Phone:706-866-2111
Mailing Address - Fax:706-866-5363
Practice Address - Street 1:1670 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4046
Practice Address - Country:US
Practice Address - Phone:706-866-2111
Practice Address - Fax:706-866-5363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty