IndividualActive
Andre Whitehead, OD
NPI 1255351672 · Optometrist · Morrow, GA
Provider details
- NPI number
- 1255351672
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- License
- OPT002221 (GA)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
2402 Southlake Mall
Morrow, GA 30260-2334
Phone: (770) 961-1001
Fax: (770) 961-4073
Approximate (ZIP-level) locationGet directions
Mailing address
11103 West Ave
San Antonio, TX 78213-1370
Registry dates
- Enumerated
- 2006-07-20
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.