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General NPI Number Information
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NPI Number | 1346465804
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Entity Type | Organization
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Legal Business Name | FOCUS EYE CARE INC.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 1570 OLD ALABAMA RD STE 106
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City | ROSWELL
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State | GA
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Zip | 30076-2108
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Country | US
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Telephone | 770-557-0039
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Fax | 678-623-3108
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Provider Business Mailing Address
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Address Line | 804 LAKEMERE CRST
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City | SUWANEE
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State | GA
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Zip | 30024-3468
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Country | US
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Telephone | 770-886-8962
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Fax | 678-807-2694
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KIMBERLY E STOVALL
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Credential |
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Telephone | 678-697-8610
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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 | GA1174
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License Number State | GA
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