Robert L Elwelljr OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000809 Issued in GA

Legal business name

ROBERT L ELWELLJR OD PC

Practice address

2256 Northlake Pkwy
#205
Tucker, GA 30084-4004

Phone

(770) 934-0337

Fax

(770) 939-5023

NPI assigned

Jan 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert L Elwell Jr., OD

Title

President

Phone

(770) 934-0337

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jarvis Johnson

  • Optometrist
  • Monticello, GA
  • NPI 1447627815
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1891766952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 NORTHLAKE PKWY",
            "address_2": "#205",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844034",
            "telephone_number": "770-934-0337",
            "fax_number": "770-939-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2256 NORTHLAKE PKWY",
            "address_2": "#205",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844004",
            "telephone_number": "770-934-0337",
            "fax_number": "770-939-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L ELWELLJR OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "ELWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-934-0337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oneika Rigby-Britton
• Rika Medical Clinic LLC
• Jessica Ringsmuth
• Rite-Eyes, Inc.
• Zina Marlena Robbins
• Robert W. Marsh, Dopc
• Alexander Ryan Roberts, MED
• Elizabeth Roberts, D.P.T., M.M.SC.
• Shanell Roberts
• Emily Ellen Robertson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.