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General NPI Number Information
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NPI Number | 1417019415
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Entity Type | Organization
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Legal Business Name | ATLANTA EYE CONSULTANTS
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1415 HOWELL MILL RD NW
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City | ATLANTA
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State | GA
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Zip | 30318-4223
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Country | US
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Telephone | 404-881-6417
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Fax | 770-996-1472
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Provider Business Mailing Address
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Address Line | 1415 HOWELL MILL RD NW
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City | ATLANTA
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State | GA
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Zip | 30318-4223
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Country | US
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Telephone | 404-881-6417
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Fax | 770-996-1472
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Authorized Official
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Title or Position | OWNER
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Name | DR. JETTIE MARITA BURNETT
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Credential | M.D.
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Telephone | 404-881-6417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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