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General NPI Number Information
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NPI Number | 1083869937
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Entity Type | Organization
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Legal Business Name | EYE-SIGHT LASER VISION CENTERS, LLC
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 3350 PEACHTREE RD NE SUITE140
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City | ATLANTA
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State | GA
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Zip | 30326-1039
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Country | US
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Telephone | 404-442-9577
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Fax | 404-442-9941
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Provider Business Mailing Address
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Address Line | 3350 PEACHTREE RD NE SUITE140
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City | ATLANTA
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State | GA
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Zip | 30326-1039
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Country | US
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Telephone | 404-442-9577
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DENNIS CLAUDE MATZKIN
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Credential |
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Telephone | 404-442-9577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 083232LGB
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License Number State | GA
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