Provider Demographics
NPI:1962524033
Name:NATU, ASFAW KINDEYA (OD)
Entity type:Individual
Prefix:DR
First Name:ASFAW
Middle Name:KINDEYA
Last Name:NATU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6303 FIVE OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8175
Mailing Address - Country:US
Mailing Address - Phone:954-732-4009
Mailing Address - Fax:404-636-5959
Practice Address - Street 1:2050 LAWRENCEVILLE HWY STE D50
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4316
Practice Address - Country:US
Practice Address - Phone:404-325-5300
Practice Address - Fax:404-636-5959
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist