Provider Demographics
NPI:1639791502
Name:WINSTON, KIRA ELISE (OD)
Entity Type:Individual
Prefix:DR
First Name:KIRA
Middle Name:ELISE
Last Name:WINSTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 KROG ST NE UNIT 222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2644
Mailing Address - Country:US
Mailing Address - Phone:678-787-6419
Mailing Address - Fax:
Practice Address - Street 1:550 EAGLES LANDING PKWY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9081
Practice Address - Country:US
Practice Address - Phone:770-474-1237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist