Provider Demographics
NPI:1366414138
Name:FLUDER, BARBARA J (OD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:FLUDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2282 E PINETREE BLVD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4807
Mailing Address - Country:US
Mailing Address - Phone:229-226-6000
Mailing Address - Fax:229-226-5859
Practice Address - Street 1:3404 GREYSTONE WAY
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-1048
Practice Address - Country:US
Practice Address - Phone:229-588-4545
Practice Address - Fax:229-588-4001
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003190152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003223201CMedicaid
GA003223201AMedicaid
GA003223201BMedicaid
IN222880Medicare PIN