EAST ATLANTA EYE SURGERY CENTER LLC NPI 1861029712

NPI Information

NPI: 1861029712
Provider Name: EAST ATLANTA EYE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D2175578

Address:
550 PROFESSIONAL DR
LAWRENCEVILLE, GA
ZIP 30046
Phone: (470) 410-8120
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EAST ATLANTA EYE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Lawrenceville, GA. EAST ATLANTA EYE SURGERY CENTER, LLC NPI is 1861029712. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

550 PROFESSIONAL DR
LAWRENCEVILLE, GA
ZIP 30046-686
Phone: (470) 410-8120

The provider's authorized official is Margaret Welborn .
The authorized official title is Nurse Manager and has the following contact phone number (470) 410-8120.

The CLIA number assigned to this NPI record is 11D2175578 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/23/2020 and was last updated on 4/6/2021.

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
1	207W00000X	Ophthalmology				No
2	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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
1	067-377	OTHER	GEORGIA	GEORGIA STATE FACILITY LICENSE

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

NPI Synchronization or Removal

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