Provider Demographics
NPI:1992943351
Name:GEORGACOPOULOS, ANNA B (OD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:B
Last Name:GEORGACOPOULOS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:680 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2644
Mailing Address - Country:US
Mailing Address - Phone:978-374-4258
Mailing Address - Fax:378-374-4982
Practice Address - Street 1:680 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-2644
Practice Address - Country:US
Practice Address - Phone:978-374-4258
Practice Address - Fax:378-374-4982
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4393152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist