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Contact Information

JILL M BAKOTA GUTIERREZ, OD
MARTIN ARMY COMMUNITY HOSPITAL
6600 VAN AALST BLVD, BLDG 9250
FORT MOORE, GA31905
 Phone: 762-408-3498
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JILL M BAKOTA GUTIERREZ · (Female)

NPI # 1932412871
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 07/21/2010
Last updated 03/11/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 0002964
  • GA License # OPT002625
  • IL License # 046010341
  • TX License # 8634 TG
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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