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General NPI Number Information
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NPI Number | 1528032034
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Entity Type | Organization
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Legal Business Name | CENTRAL GEORGIA EYE DESIGNS, INC.
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 1429 OGLETHORPE ST
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City | MACON
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State | GA
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Zip | 31201-1512
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Country | US
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Telephone | 478-743-1342
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Fax | 478-743-6296
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-8575
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Country | US
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Telephone | 478-743-1342
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Fax | 478-743-6296
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. DIANE N VAUGHN
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Credential |
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Telephone | 478-743-1342
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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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