Provider Demographics
NPI:1760588636
Name:SCHNOBRICH, TODD ANDREW (OD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ANDREW
Last Name:SCHNOBRICH
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 1:1000 TOWNE CENTER BLVD
Mailing Address - Street 2:STE 502
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4068
Mailing Address - Country:US
Mailing Address - Phone:912-826-7462
Mailing Address - Fax:
Practice Address - Street 1:1000 TOWNE CENTER BLVD
Practice Address - Street 2:SUITE # 502
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4052
Practice Address - Country:US
Practice Address - Phone:912-748-1272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT1806152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000870229BMedicaid
GA000870299CMedicaid
GA101542OtherAVESIS