Provider Demographics
NPI:1881342178
Name:LI, MEGAN (OD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LI
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 1:572 HANK AARON DR SE STE 1130
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2896
Mailing Address - Country:US
Mailing Address - Phone:404-538-8215
Mailing Address - Fax:
Practice Address - Street 1:572 HANK AARON DR SE STE 1130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2896
Practice Address - Country:US
Practice Address - Phone:404-205-5669
Practice Address - Fax:404-205-5714
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003398152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty