MEDICARE: CLARITY VISION GROUP, 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
1	152W00000X	Optometrist	OPT002749	GA
2	152W00000X	Optometrist	OPT001674	GA

General Provider Information

NPI Number	:	1578924700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARITY VISION GROUP, LLC

Provider Business Mailing Address
First Line	:	1780 PEACHTREE PKWY
Second Line	:	STE 301
City	:	CUMMING
State	:	GA
Zip	:	30041-6834
Country	:	US
Telephone Number	:	770-205-2520
Fax Number	:	770-456-5994

Provider Business Practice Location Address
First Line	:	1780 PEACHTREE PKWY
Second Line	:	STE 301
City	:	CUMMING
State	:	GA
Zip	:	30041-6834
Country	:	US
Telephone Number	:	770-205-2520
Fax Number	:	770-456-5994

Authorized Official
Title or Position	:	INSURANCE COORDINATOR
Name	:	MS. DIANA M LOHRMANN
Credential	:
Telephone Number	:	770-205-2520

Provider Enumeration Date	:	03/16/2016
Last Update Date	:	08/16/2017

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