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SOUTHERN OCULAR PROSTHETICS LLC NPI 1417673591


NPI Information

NPI: 1417673591
Provider Name: SOUTHERN OCULAR PROSTHETICS, LLC
Classification: Technician/Technologist - 156FX1700X
Entity Type: Organization

Specialization: Ocularist

Address:
2801 N DECATUR RD STE 130
DECATUR, GA
ZIP 30033
Phone: (470) 296-2152
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SOUTHERN OCULAR PROSTHETICS, LLC is an ocularist technician technologist in Decatur, GA. The provider is an ocularist is a thoroughly trained professional skilled in the art of fitting, painting, and fabricating custom ocular prostheses. In addition to creating custom ocular prostheses, and providing long-term care through periodic examinations, an ocularist provides the patient with complete instructions on the care and maintenance of their prosthesis. SOUTHERN OCULAR PROSTHETICS, LLC NPI is 1417673591. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2801 N DECATUR RD STE 130
DECATUR, GA
ZIP 30033-049
Phone: (470) 296-2152

The provider's authorized official is Antonio Louis Alcorta .
The authorized official title is President and has the following contact phone number (559) 940-1189.

The enumeration date for this NPI number is 10/19/2022 and was last updated on 10/19/2022.


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
1156FX1700XTechnician/TechnologistOcularistYes

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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