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General NPI Number Information
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NPI Number | 1538823315
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Entity Type | Organization
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Legal Business Name | ADAIRSVILLE EYE ASSOCIATES LLC
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 14 LEGACY WAY STE D
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City | ADAIRSVILLE
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State | GA
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Zip | 30103-2455
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Country | US
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Telephone | 770-773-1584
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Fax |
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Provider Business Mailing Address
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Address Line | 14 LEGACY WAY STE D
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City | ADAIRSVILLE
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State | GA
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Zip | 30103-2455
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Country | US
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Telephone | 770-773-1584
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL DO
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Credential | OD
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Telephone | 561-313-8647
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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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