Provider Demographics
NPI:1811090921
Name:RINER, PATRICK M (OD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:M
Last Name:RINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 HWY 144 # 291
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-7349
Mailing Address - Country:US
Mailing Address - Phone:912-530-8528
Mailing Address - Fax:
Practice Address - Street 1:751 W OGLETHORPE HWY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4416
Practice Address - Country:US
Practice Address - Phone:912-530-8528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT000489152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA350266687AMedicaid
GAU94901Medicare UPIN
GA350266687AMedicaid