Provider Demographics
NPI:1932331006
Name:SCHAGREN, PAMELA (OD)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:SCHAGREN
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 1:880 CRESTMARK DR
Mailing Address - Street 2:STE 101
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2646
Mailing Address - Country:US
Mailing Address - Phone:770-948-0036
Mailing Address - Fax:
Practice Address - Street 1:880 CRESTMARK DR
Practice Address - Street 2:STE 101
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2646
Practice Address - Country:US
Practice Address - Phone:770-948-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002470152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist