SOUTH GEORGIA EYE PARTNERS NPI 1093077984

NPI Information

  • NPI: 1093077984
  • Provider Name: SOUTH GEORGIA EYE PARTNERS
  • Classification: Ophthalmology - 207W00000X
  • Entity Type: Organization
  • CLIA Number: 11D2068055
  • Address: 416 TIFT AVE N
    TIFTON, GA
    ZIP 31794
  • Phone: (229) 391-4180

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NPI Details

SOUTH GEORGIA EYE PARTNERS is an ophthalmology in Tifton, GA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. SOUTH GEORGIA EYE PARTNERS NPI is 1093077984. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

416 TIFT AVE N
TIFTON, GA
ZIP 31794-466
Phone: (229) 391-4180
Fax: (229) 391-2929

The provider's authorized official is Scott H Petermann .
The authorized official title is Owner and has the following contact phone number (229) 391-4126.

The CLIA number assigned to this NPI record is 11D2068055 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/15/2012 and was last updated on 6/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristNo
2152WC0802XOptometristCorneal and Contact ManagementNo
3152WP0200XOptometristPediatricsNo
4152WS0006XOptometristSports VisionNo
5332H00000XEyewear SupplierNo
6207W00000XOphthalmologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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