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CARROLLTON EYE CLINIC PC NPI 1346357928


NPI Information

NPI: 1346357928
Provider Name: CARROLLTON EYE CLINIC, PC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 11D2270943

Address:
158 CLINIC AVE
CARROLLTON, GA
ZIP 30117
Phone: (770) 834-1008
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CARROLLTON EYE CLINIC, PC is an ophthalmology in Carrollton, 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. CARROLLTON EYE CLINIC, PC NPI is 1346357928. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

158 CLINIC AVE
CARROLLTON, GA
ZIP 30117-414
Phone: (770) 834-1008
Fax: (770) 834-2531

The provider's authorized official is Angie Bradley .
The authorized official title is Administrator and has the following contact phone number (770) 834-1008.

The CLIA number assigned to this NPI record is 11D2270943 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 12/16/2009.


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
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP445MEDICARE PINGEORGIA
2300022259AMEDICAIDGEORGIA

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: 5/5/2024

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