Healthcare Provider Details

I. General information

NPI: 1700924636
Provider Name (Legal Business Name): UPTOWN EYECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W BROUGHTON ST
SAVANNAH GA
31401-3211
US

IV. Provider business mailing address

101 W BROUGHTON ST
SAVANNAH GA
31401-3211
US

V. Phone/Fax

Practice location:
  • Phone: 912-234-9214
  • Fax: 912-234-7390
Mailing address:
  • Phone: 912-234-9214
  • Fax: 912-234-7390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number302625951
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number302625951
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number302625951
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number302625951
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number302625951
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number302625951
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number302625951
License Number StateGA
# 8
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number302625951
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier154675884A
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer

VIII. Authorized Official

Name: DR. LEWIS STEINFELD
Title or Position: PRESIDENT
Credential: O.D.
Phone: 912-234-9214