| Organization Name: | PARKWAY FAMILY OPTICAL |
| NPI Number: | 1083931950 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICKY SCHERRELLE BYNUM (OWNER) |
| Mailing Address: | 530 Forest Pkwy Ste D Forest Park |
| State: | GA US |
| Postal Code: | 302972188 |
| Phone Number: | 4043669822 |
| Fax Number: | 4046088591 |
| NPI Enumeration Date: | 04/30/2010 |
| NPI Last Update Date: | 04/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |