Provider Type Icon

ETOWAH EYE CLINIC P.C. NPI 1932322302


NPI Information

NPI: 1932322302
Provider Name: ETOWAH EYE CLINIC, P.C.
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
125 OAKSIDE CT
SUITE 102
CANTON, GA
ZIP 30114
Phone: (678) 880-0662
Get Directions

ETOWAH EYE CLINIC, P.C. is an ophthalmology in Canton, 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. ETOWAH EYE CLINIC, P.C. NPI is 1932322302. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

125 OAKSIDE CT
SUITE 102
CANTON, GA
ZIP 30114-498
Phone: (678) 880-0662
Fax: (678) 880-0675

The provider's authorized official is William Parker Marks .
The authorized official title is Owner Physician and has the following contact phone number (678) 880-0662.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 1/15/2008.


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
1207W00000XOphthalmology030829GEORGIAYes

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
1E84469MEDICARE UPINGEORGIA
2GRP4786MEDICARE ID-TYPE UNSPECIFIEDGEORGIAGROUP NUMBER
34771660001MEDICARE NSCGEORGIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.