Provider Demographics
NPI:1710041553
Name:OPTIKS INC
Entity Type:Organization
Organization Name:OPTIKS INC
Other - Org Name:DENNIS L COWART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-537-5246
Mailing Address - Street 1:207 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-2021
Mailing Address - Country:US
Mailing Address - Phone:770-537-5246
Mailing Address - Fax:770-537-1313
Practice Address - Street 1:207 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-2021
Practice Address - Country:US
Practice Address - Phone:770-537-5246
Practice Address - Fax:770-537-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT000902152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA585146283GMedicaid
GA6985178OtherCIGNA
GA2784905OtherUNITED HEALTH CARE
GA000204256AMedicaid
GA713909OtherCOVENTRY
GA7369863OtherAETNA
GA713909OtherCOVENTRY
GA2784905OtherUNITED HEALTH CARE
GA511I180006Medicare PIN
GA202G702815Medicare PIN