Provider Demographics
NPI:1407913858
Name:RAMOS WERNER, BRENDA YVONNE (OD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:YVONNE
Last Name:RAMOS WERNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:YVONNE
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24 PEEKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-3125
Mailing Address - Country:US
Mailing Address - Phone:770-230-0700
Mailing Address - Fax:770-230-0707
Practice Address - Street 1:24 PEEKSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3125
Practice Address - Country:US
Practice Address - Phone:770-230-0700
Practice Address - Fax:770-230-0707
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00921152W00000X
GAOPT001921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA632075017DMedicaid
GAU85908Medicare UPIN