Provider Demographics
NPI:1912225731
Name:KOLOZE, BARBARA (OD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:KOLOZE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4280 E WEST CONNECTOR SE
Mailing Address - Street 2:SMYRNA
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4804
Mailing Address - Country:US
Mailing Address - Phone:770-435-4457
Mailing Address - Fax:770-435-4555
Practice Address - Street 1:4280 E WEST CONNECTOR SE
Practice Address - Street 2:SMYRNA
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-4804
Practice Address - Country:US
Practice Address - Phone:770-435-4457
Practice Address - Fax:770-435-4555
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAOPT002634152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist