Provider Demographics
NPI:1619902384
Name:SINGH, LAKHVIR (OD)
Entity Type:Individual
Prefix:
First Name:LAKHVIR
Middle Name:
Last Name:SINGH
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 1:5901A PEACHTREE DUNWOODY RD
Mailing Address - Street 2:STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5341
Mailing Address - Country:US
Mailing Address - Phone:678-781-7373
Mailing Address - Fax:678-538-1972
Practice Address - Street 1:149 TOWNE LAKE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4860
Practice Address - Country:US
Practice Address - Phone:770-928-4544
Practice Address - Fax:404-256-1981
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002119152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA304162810SMedicaid
GA304162810RMedicaid
GA304162810RMedicaid