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General NPI Number Information
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NPI Number | 1497882500
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Entity Type | Organization
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Legal Business Name | NORTH GEORGIA EYE CLINIC, PC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 1485 JESSE JEWELL PARKWAY NE SUITE 100
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City | GAINESVILLE
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State | GA
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Zip | 30501-3806
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Country | US
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Telephone | 770-534-1711
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Fax | 770-534-9158
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Provider Business Mailing Address
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Address Line | 1485 JESSE JEWELL PARKWAY NE SUITE 100
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City | GAINESVILLE
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State | GA
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Zip | 30501-3806
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Country | US
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Telephone | 770-534-1711
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Fax | 770-534-9158
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY J PAYNE
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Credential | M.D.
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Telephone | 770-534-1711
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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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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 156FX1900X
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Taxonomy Name | Orthoptist
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number |
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License Number State |
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