Provider Demographics
NPI:1750904397
Name:CHO, SOHYUN (OD)
Entity type:Individual
Prefix:
First Name:SOHYUN
Middle Name:
Last Name:CHO
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 1:14 LEGACY WAY STE D
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-2455
Mailing Address - Country:US
Mailing Address - Phone:770-773-1584
Mailing Address - Fax:770-773-2773
Practice Address - Street 1:14 LEGACY WAY STE D
Practice Address - Street 2:
Practice Address - City:ADAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30103-2455
Practice Address - Country:US
Practice Address - Phone:770-773-1584
Practice Address - Fax:770-773-2773
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist