Provider Demographics
NPI:1225850068
Name:MICHALSKI, JAMES (LDO)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MICHALSKI
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 BELLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-2317
Mailing Address - Country:US
Mailing Address - Phone:770-926-4810
Mailing Address - Fax:770-926-4826
Practice Address - Street 1:6435 BELLS FERRY RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-2317
Practice Address - Country:US
Practice Address - Phone:770-926-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALDO002571156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician