Provider Demographics
NPI:1104907062
Name:ANDERSON, CARLA D (OD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:D
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:3730 CARMIA DR SW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-6258
Mailing Address - Country:US
Mailing Address - Phone:404-344-4136
Mailing Address - Fax:404-346-7140
Practice Address - Street 1:3730 CARMIA DR SW
Practice Address - Street 2:STE 310
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-6258
Practice Address - Country:US
Practice Address - Phone:404-344-4136
Practice Address - Fax:404-346-7140
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2010-05-05
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Provider Licenses
StateLicense IDTaxonomies
GAOPT002289152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist