Provider Demographics
NPI:1013129352
Name:FERRIS, ERIC M (OD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:FERRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:705 JESSE JEWELL PKWY SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3867
Mailing Address - Country:US
Mailing Address - Phone:770-532-9639
Mailing Address - Fax:
Practice Address - Street 1:705 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE 100
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3867
Practice Address - Country:US
Practice Address - Phone:770-532-9639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002325152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist