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SOUTHERN EYE CENTER PC NPI 1316020043


NPI Information

NPI: 1316020043
Provider Name: SOUTHERN EYE CENTER, PC

Doing Business As: SOUTHERN EYE CENTER, PC

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2310 N PATTERSON ST
SUITE B
VALDOSTA, GA
ZIP 31602
Phone: (229) 247-2020
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SOUTHERN EYE CENTER, PC is a specialist in Valdosta, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHERN EYE CENTER, PC NPI is 1316020043. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southern Eye Center, Pc.

The provider's business location address is:

2310 N PATTERSON ST
SUITE B
VALDOSTA, GA
ZIP 31602-568
Phone: (229) 247-2020
Fax: (229) 247-5600

The provider's authorized official is Mark Joseph Eanes .
The authorized official title is President and has the following contact phone number (229) 247-2020.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 11/1/2011.


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
1152W00000XOptometristOPT002069GEORGIANo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3174400000XSpecialist025970GEORGIAYes

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
10686710001MEDICARE NSCGEORGIA
2GRP343MEDICARE ID-TYPE UNSPECIFIEDGEORGIAGEORGIA MEDICARE

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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