Provider Demographics
NPI:1609861129
Name:HARTON, RICKEY JR (OD)
Entity Type:Individual
Prefix:DR
First Name:RICKEY
Middle Name:
Last Name:HARTON
Suffix:JR
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 1:3353 MERCER UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31206
Mailing Address - Country:US
Mailing Address - Phone:478-745-1515
Mailing Address - Fax:478-745-1533
Practice Address - Street 1:3353 MERCER UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206
Practice Address - Country:US
Practice Address - Phone:478-745-1515
Practice Address - Fax:478-745-1533
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPOP165152W00000X
MO2022041049152W00000X
TX10731T152W00000X
UT12955090-9934152W00000X
MDTA2978152W00000X
NY009924152W00000X
GAOPT 002577152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist