Washington, Edward Theodore

Washington, Edward Theodore is an individual health care provider with primary practice located at 4045 Wetherburn Way Ste 1 , Norcross GA 30092-4611. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Glaucoma Specialist. Allopathic & Osteopathic Physicians / Glaucoma Specialist is his primary health care specialty. Washington, Edward Theodore can be contacted via phone (770) 285-7910.

Contact Information

Primary practice address
4045 Wetherburn Way Ste 1 Norcross GA 30092-4611
Phone: (770) 285-7910
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 312393 Louisiana
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 57027483 Ohio
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X TP126 Kentucky
Allopathic & Osteopathic Physicians / Glaucoma Specialist 207WX0009X 91739 Georgia

Profile Details

NPI number 1104211283
LBN Legal business name Washington, Edward Theodore
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2015
Last updated Aug 30th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104211283 NPPES
Indiana MEDICAID 300039071
Indiana MEDICAID 7100669250

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