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Contact Information

JEFFERY L SPONSELLER, OD
3152 WASHINGTON RD
AUGUSTA, GA30907
 Phone: 706-651-1291
 Fax: 706-210-8090
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JEFFERY L SPONSELLER · (Male)

NPI # 1033177563
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/03/2006
Last updated 06/15/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • GA License # OPT002159
  • SC License # 1425
  • GA Medicaid 519944203B
  • SC Medicaid DG2159
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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