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General NPI Number Information
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NPI Number | 1467735829
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Entity Type | Organization
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Legal Business Name | QUALITY EYECARE
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 5900 SUGARLOAF PKWY SUITE 513
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7857
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Country | US
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Telephone | 678-847-5331
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Fax | 678-847-5333
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Provider Business Mailing Address
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Address Line | 5900 SUGARLOAF PKWY SUITE 513
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7857
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Country | US
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Telephone | 678-847-5331
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Fax | 678-847-5333
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARL JOHNSEY JR.
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Credential | O.D.
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Telephone | 678-847-5331
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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 | OPT001445
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License Number State | GA
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