Shundale Thomas Mixon, OD

NPI #1013403088 in Suwanee, Georgia

Provider Information

NPI Number: 1013403088
Entity Type: Individual
Name: Shundale Thomas Mixon, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jul 2, 2018
Last Updated: Oct 4, 2023

Practice Location

Address: 1300 PEACHTREE INDUSTRIAL BLVD STE 1206
City: Suwanee
State: Georgia
ZIP Code: 30024-4550
Phone: (334) 318-0713

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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