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General NPI Number Information
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NPI Number | 1225086721
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Entity Type | Organization
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Legal Business Name | AUGUSTA EYE MD, PC
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 905 STEVENS CREEK RD STE A
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City | AUGUSTA
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State | GA
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Zip | 30907-3201
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Country | US
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Telephone | 706-922-6000
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Fax | 706-722-7994
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Provider Business Mailing Address
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Address Line | 905 STEVENS CREEK RD STE A
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City | AUGUSTA
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State | GA
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Zip | 30907-3201
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Country | US
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Telephone | 706-922-6000
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Fax | 706-722-7994
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | STUART D. MARKS
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Credential | MD
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Telephone | 706-922-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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