Paxson, Clint D
Paxson, Clint D is an sole proprietor health care provider with primary practice located at 1014 Northside Dr E , Statesboro GA 30458-1002. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Paxson, Clint D can be contacted via phone (912) 764-9147.Contact Information
Primary practice address
1014 Northside Dr E
Statesboro GA 30458-1002
Phone: (912) 764-9147
Fax: (912) 764-3250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1401 | South Carolina |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT002932 | Georgia |
Profile Details
| NPI number | 1346216546 |
|---|---|
| LBN Legal business name | Paxson, Clint D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2006 |
| Last updated | Oct 20th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346216546 | NPPES |
| Georgia | MEDICAID | 003219828A | |
| Georgia | MEDICAID | D14018 |
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