Healthcare Provider Details

I. General information

NPI: 1255974630
Provider Name (Legal Business Name): THOMAS EYE GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2019
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 HAMILTON CREEK PKWY STE 1100
DACULA GA
30019-4515
US

IV. Provider business mailing address

5901 PEACHTREE DUNWOODY RD STE A500
ATLANTA GA
30328-7162
US

V. Phone/Fax

Practice location:
  • Phone: 678-892-2020
  • Fax: 678-538-1950
Mailing address:
  • Phone: 678-781-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL L KAUFMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 678-892-2020