Provider Demographics
NPI:1962437707
Name:ACHIONYE, ONYINYECHI (OD)
Entity type:Individual
Prefix:
First Name:ONYINYECHI
Middle Name:
Last Name:ACHIONYE
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 1:8225 MALL PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6994
Mailing Address - Country:US
Mailing Address - Phone:678-526-7782
Mailing Address - Fax:678-710-9907
Practice Address - Street 1:8225 MALL PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6994
Practice Address - Country:US
Practice Address - Phone:678-526-7782
Practice Address - Fax:678-710-9907
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002224152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA407665514OMedicaid