Organization Name: | EYE INSTITUTE OF NORTH GEORGIA, PC |
NPI Number: | 1871611707 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAY M FREEMAN (OWNER) |
Mailing Address: | 299 Hurricane Shoals Rd Nw Lawrenceville |
State: | GA US |
Postal Code: | 300454420 |
Phone Number: | 7703396085 |
Fax Number: | 7703396146 |
NPI Enumeration Date: | 03/27/2007 |
NPI Last Update Date: | 02/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 07/27/2007 |
NPI Reactivation Date: | 01/11/2008 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 032186 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |