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General NPI Number Information
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NPI Number | 1093361404
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Entity Type | Organization
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Legal Business Name | EYEDEAL EYECARE LLC
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 1133 E WEST CONNECTOR
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City | AUSTELL
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State | GA
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Zip | 30106-1779
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Country | US
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Telephone | 770-863-9421
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 E WEST CONNECTOR
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City | AUSTELL
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State | GA
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Zip | 30106-1779
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANIS JAMES
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Credential | OD
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Telephone | 770-863-9421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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