Provider Demographics
NPI:1700774122
Name:NARAIN, VAISHNAVI T (OD)
Entity type:Individual
Prefix:
First Name:VAISHNAVI
Middle Name:T
Last Name:NARAIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-0187
Mailing Address - Country:US
Mailing Address - Phone:478-988-1124
Mailing Address - Fax:
Practice Address - Street 1:110 SOUTHPOINT BLVD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-7320
Practice Address - Country:US
Practice Address - Phone:770-228-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003692152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist