IndividualActive
Alisa Nicholson, OD
NPI 1790186211 · Optometrist · Douglasville, GA
Provider details
- NPI number
- 1790186211
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Female
- Sole proprietor
- Yes
- License
- OPT002881 (GA)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
6700 Douglas Blvd Ste 1270
Douglasville, GA 30135
Phone: (770) 942-9827
Approximate (ZIP-level) locationGet directions
Mailing address
6700 Douglas Blvd Ste 1270
Douglasville, GA 30135-1590
Registry dates
- Enumerated
- 2014-09-16
- Last updated
- 2020-04-30
- Certified
- 2020-04-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.