Provider Demographics
NPI:1932894649
Name:SCHEURER, TAYLOR DANIELLE (OD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:DANIELLE
Last Name:SCHEURER
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 1:11320 TRUDIE ROAD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:GA
Mailing Address - Zip Code:31557
Mailing Address - Country:US
Mailing Address - Phone:231-920-4157
Mailing Address - Fax:
Practice Address - Street 1:240 TANGER OUTLETS BLVD SUITE 108
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4389
Practice Address - Country:US
Practice Address - Phone:912-348-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003497152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist