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NPI Code Detail

MEDICARE: LEX-MARQ OPTIQUE LLC

MEDICARE: LEX-MARQ OPTIQUE LLC
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
1305S00000XPoint of Service

General Provider Information

NPI Number : 1568769198
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEX-MARQ OPTIQUE LLC
Provider Business Mailing Address
First Line : 201 17TH ST NW
Second Line : STE 300
City : ATLANTA
State : GA
Zip : 30363-1098
Country : US
Telephone Number : 866-927-4759
Fax Number : 866-927-4759
Provider Business Practice Location Address
First Line : 201 17TH ST NW
Second Line : STE 300
City : ATLANTA
State : GA
Zip : 30363-1098
Country : US
Telephone Number : 866-927-4759
Fax Number : 866-927-4759
Authorized Official
Title or Position : OWNER
Name : JERRY PAGE
Credential :
Telephone Number : 866-927-4759
Provider Enumeration Date : 02/17/2011
Last Update Date : 02/15/2013

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Directions to “LEX-MARQ OPTIQUE LLC ” Practice Location

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