Healthcare Provider Details

I. General information

NPI: 1437352812
Provider Name (Legal Business Name): CHOI EYE INSTITUTE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DR SUITE 102
DALTON GA
30720-8662
US

IV. Provider business mailing address

1107 MEMORIAL DR SUITE 102
DALTON GA
30720-8662
US

V. Phone/Fax

Practice location:
  • Phone: 706-529-8733
  • Fax: 706-275-0354
Mailing address:
  • Phone: 706-529-8733
  • Fax: 706-275-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number056275
License Number StateGA

VIII. Authorized Official

Name: DR. YOUNG HWAN CHOI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 423-544-7236