DR. JAMES STALLWORTH PACK (NPI# 1649356106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649356106 |
| Entity Type | Individual |
| Full Name | DR. JAMES STALLWORTH PACK |
| Credential | O.D. |
| Practice Address |
4475 Roswell Rd Ste: 1430 Marietta GA 30062-8193 |
| Mailing Address |
735 Willow Ridge Ct Marietta GA 30068-5202 |
| Practice Telephone | 7705099932 |
| Practice Fax Number | 7705092612 |
| Mailing Telephone | 7705651134 |
| Mailing Fax Number | 7705092612 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
1201 | GA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164564811 | James Walter Pack | Physician Assistant | 750 Oakwilde Ct, Millersville, MD 21108-1447 | 2007-02-12 |
| Street Address |
4475 ROSWELL RD STE: 1430 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-8193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720217771 | Advanced Eye Associates LLC | Optometrist | 2645 Dallas Hwy Sw, Suite 100, Marietta, GA 30064-2541 | 2009-07-13 |
| 1780654483 | Eye To Eye Vision Center | Optometrist | 2255 Sewell Mill Rd, Suite 310, Marietta, GA 30062-2804 | 2006-01-25 |
| 1386193548 | Marvin Howell, Od and Associates | Optometrist | 4101 Roswell Rd, Marietta, GA 30062-6293 | 2016-09-29 |
| 1083042253 | Northside Eye Partners, PC | Optometrist | 2230 Roswell Rd, Suite 100, Marietta, GA 30062-2939 | 2013-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437791076 | Shipley & Wayland Eyecare LLC | Optometrist | 7768 Cumming Hwy Ste 500, Canton, GA 30115-2984 | 2019-10-15 |
| 1023463528 | Eminence Family Eyecare, LLC | Optometrist | 6300 Atlanta Hwy # 9, Suite 101a, Alpharetta, GA 30004-7821 | 2016-05-03 |
| 1689066284 | Dr James L Purvis, LLC | Optometrist | 7104 Waterstone Pl, Buford, GA 30518-5125 | 2015-02-19 |
| 1679878524 | Optique At Brookhaven, LLC | Optometrist | 305 Brookhaven Ave, Sw 1110, Atlanta, GA 30319-4316 | 2011-01-24 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| 1952617300 | Sima Dori | Optometrist | 2204 Cherring Ln, Dunwoody, GA 30338-5229 | 2010-08-24 |
| 1750541355 | Mcarthur Griffin | Optometrist | 1700 Mount Zion Rd, Morrow, GA 30260-3014 | 2008-06-17 |
| 1942428362 | Farhad Kapadia | Optometrist | 2994 Turner Hill Rd, Lithonia, GA 30038-2526 | 2007-04-23 |
| 1225161185 | Robert Joseph Barnes | Optometrist | 650 Ponce De Leon Ave Ne, Suite 630a, Atlanta, GA 30308-1804 | 2007-03-13 |
| 1326174400 | John Christy Snyder | Optometrist | 135 N Broad St, Winder, GA 30680-2110 | 2007-02-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.