Edward H Pottlitzer OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000700 Issued in GA

Legal business name

EDWARD H POTTLITZER OD PC

Practice address

2911 Chapel Hill Rd
Suite 210
Douglasville, GA 30135

Phone

(770) 949-4223

Fax

(770) 949-4994

NPI assigned

Mar 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward Herman Pottlitzer, ODNPI 1164555942

Title

Owner President

Phone

(770) 949-4223

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Herman Pottlitzer, OD

  • Optometrist
  • Douglasville, GA
  • NPI 1164555942
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124151907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 CHAPEL HILL RD",
            "address_2": "SUITE 210",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30135",
            "telephone_number": "770-949-4223",
            "fax_number": "770-949-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 CHAPEL HILL RD",
            "address_2": "SUITE 210",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30135",
            "telephone_number": "770-949-4223",
            "fax_number": "770-949-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD H POTTLITZER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POTTLITZER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "HERMAN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "770-949-4223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79949",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.