Provider Demographics
NPI:1457356974
Name:MCQUAIG, CHARLES STEPHEN II (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:STEPHEN
Last Name:MCQUAIG
Suffix:II
Gender:M
Credentials:OD
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Mailing Address - Street 1:111 FIELDSTONE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061
Mailing Address - Country:US
Mailing Address - Phone:478-453-9333
Mailing Address - Fax:478-453-7760
Practice Address - Street 1:111 FIELDSTONE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:478-453-9333
Practice Address - Fax:478-453-7760
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2015-01-28
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Provider Licenses
StateLicense IDTaxonomies
GAOPT002029152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA41ZCFCDOtherPTAN