Healthcare Provider Details

I. General information

NPI: 1548384738
Provider Name (Legal Business Name): ATLANTA OPHTHALMOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 D JOHNSON FERRY RD SUITE 250
ATLANTA GA
30342
US

IV. Provider business mailing address

993 D JOHNSON FERRY RD SUITE 250
ATLANTA GA
30342
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-1194
  • Fax: 404-252-3150
Mailing address:
  • Phone: 404-252-1194
  • Fax: 404-252-3150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberGA030728
License Number StateGA

VIII. Authorized Official

Name: DR. DAVID A PALAY
Title or Position: PARTNER
Credential: MD
Phone: 404-252-1194