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NPI Code Detail

MEDICARE: GEORGIA EYE INSTITUTE, INC.

MEDICARE: GEORGIA EYE INSTITUTE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianGA
2152W00000XOptometristGA

General Provider Information

NPI Number : 1235343807
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEORGIA EYE INSTITUTE, INC.
Provider Business Mailing Address
First Line : PO BOX 931989
Second Line :
City : ATLANTA
State : GA
Zip : 31193-0001
Country : US
Telephone Number : 912-350-4800
Fax Number : 912-350-4821
Provider Business Practice Location Address
First Line : 206 MAPLE DR
Second Line :
City : VIDALIA
State : GA
Zip : 30474-8907
Country : US
Telephone Number : 912-537-2020
Fax Number : 912-350-4821
Authorized Official
Title or Position : PROVIDER ENROLLMENT COORDINATOR
Name : MRS. ROBIN J. MADDOX
Credential :
Telephone Number : 912-350-9335
Provider Enumeration Date : 05/10/2007
Last Update Date : 09/11/2025

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Directions to “GEORGIA EYE INSTITUTE, INC. ” Practice Location

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