NPI 1205930666 · live from the CMS NPI Registry
Atlanta Eye Center, LLC
Optometrist in Atlanta, GA. National Provider Identifier 1205930666, active.
NPI record
| NPI | 1205930666 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1801 Howell Mill Rd, Wal-Mart Vision Center #3775, Atlanta, GA 30318 |
| Practice phone | 404-352-3414 |
| Mailing address | 4717 Cambridge Trce, Dunwoody, GA 30338 |
| Enumerated | September 7, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Kim Raharja, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | OPT2319 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.