| Organization Name: | GEORGIA OPHTHALMOLOGY ASSOC PC |
| NPI Number: | 1033246525 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | P SANFORD (ADMINISTRATOR) |
| Mailing Address: | 1700 Tree Lane Rd Suite 135 Snellville |
| State: | GA US |
| Postal Code: | 300786782 |
| Phone Number: | 4042985557 |
| Fax Number: | 4042979480 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 08/23/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 017845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |