Provider Demographics
NPI:1740064096
Name:ODION, MARGARET IKHUOHUOLEGBE (LDO)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:IKHUOHUOLEGBE
Last Name:ODION
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5542 WELLBORN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3547
Mailing Address - Country:US
Mailing Address - Phone:301-655-4616
Mailing Address - Fax:
Practice Address - Street 1:5542 WELLBORN CREEK DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3547
Practice Address - Country:US
Practice Address - Phone:301-655-4616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002640156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician