Healthcare Provider Details

I. General information

NPI: 1992686448
Provider Name (Legal Business Name): OCULARE PERSONALIZED EYECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 NORTHSIDE PKWY NW STE 220
ATLANTA GA
30327-2886
US

IV. Provider business mailing address

3715 NORTHSIDE PKWY NW STE 220
ATLANTA GA
30327-2886
US

V. Phone/Fax

Practice location:
  • Phone: 404-380-1500
  • Fax:
Mailing address:
  • Phone: 404-380-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. GAVIN COHEN
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: OD
Phone: 404-405-8539